Podcasts about American Psychiatric Association

Dr. Jason Tucciarone and Dr. Alan Schatzberg (Stanford University, Stanford, CA) join AJP Audio to discuss the use of low-dose buprenorphine as an adjunctive therapy to extend the anti-suicidal effects of ketamine treatment in patients with major depressive disorder and suicidal ideation.  AJP Editor-in-Chief Dr. Ned Kalin joins to discuss the rest of the June issue of the Journal, which takes a close look at issues surrounding suicide and severe depression. 01:20     Tucciarone and Schatzberg interview 03:36     Disparity between effects on suicidal ideation and antidepressant ratings 05:36     Ethics of placebo and ketamine in patients with suicidal ideation 08:28     Immediate clinical implications 11:40     Limitations 14:10     Further research 16:19     Kalin interview 16:24     Tucciarone et al. 20:39     Rovers et al. 24:30     Jelen et al. Transcript Board-certified psychiatrists, if you're seeking meaningful inpatient work with real clinical autonomy, consider becoming the Clinical Director for a 16-bed behavioral health hospital in Fergus Falls or Bemidji, Minnesota. You'll lead a supportive interdisciplinary team, enjoy predictable work-life balance, and have opportunities for teaching and mentorship without RVU pressure or third-party billing. Learn more on APA's Career Center, JobCentral, by searching Direct Care and Treatment – State of Minnesota. Direct Care and Treatment – State of Minnesota:  bit.ly/DCTClinicalDirector Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

10:05 – 10:22 (17mins) Weekly: Tim Jones “The Tim Jones and Chris Arps Show” weekdays 4p-6p on NewstalkSTL 10:41 – 10:56 (15mins) Dr. Carole Lieberman, @DrCaroleMD M.D., M.P.H. known world-wide as America’s Psychiatrist and the Terrorist Therapist, is the host of Dr. Carole’s Couch on VoiceAmerica.com, and The Terrorist Therapist® Podcast.has spent more than a year researching what she calls “Trump Derangement Syndrome” (TDS) — a term commonly used in political and cultural debate to describe extreme emotional and behavioral reactions to President Donald Trump. DIAGNOSIS: “Trump Derangement Syndrome” — Psychiatrist Proposes Criteria for APA ReviewCould Extreme Political Obsession Become a Mental Health Diagnosis? Dr. Lieberman has drafted proposed diagnostic criteria that she plans to submit to the American Psychiatric Association for consideration and public discussion. Her framework categorizes cases as Mild, Moderate, and Severe, accompanied by real-world behavioral examples and analysis of the psychological and social factors she believes contribute to the condition.See omnystudio.com/listener for privacy information.

Judith Herman is widely known as a defining voice in trauma psychiatry for more than fifty years. Her work bridges the personal and the political, framing trauma as not only an individual experience, but a public health and human rights issue. In this interview with host Patricia Martin, Judith Herman tells the story of how her work evolved, what remains to be done for CPTSD victims, and what all of us can do to create conditions survivors need to heal. Judith Lewis Herman, MD, is Professor of Psychiatry (part time) at Harvard Medical School. For 30 years, until she retired, she was Director of Training at the Victims of Violence Program at The Cambridge Hospital, Cambridge, MA. She is the author of the award-winning books Father–Daughter Incest (Harvard University Press, 1981), and Trauma and Recovery (Basic Books, 1992). She is the recipient of numerous awards, including a Guggenheim fellowship in 1984 and the 1996 Lifetime Achievement Award from the International Society for Traumatic Stress Studies. In 2007 she was named a Distinguished Life Fellow of the American Psychiatric Association. Her new book, Truth and Repair: How Trauma Survivors Envision Justice, was published in March, 2023. Books by Judith Herman: Patricia Martin, MFA, is the host of Jung in the World. A noted cultural analyst, she applies Jungian theory to her work as a researcher and writer. Author of three books, her work has been featured in the New York Times, Harvard Business Review, Huffington Post, and USA Today. She holds an MFA in writing and literature from Bennington College and an MA in cultural studies at the University College, Dublin (honors). In 2018, she completed the Jungian Studies Program at the C. G. Jung Institute Chicago where she is a professional affiliate. A scholar in residence at the Chicago Public Library, for the last decade she's been studying the digital culture and its impact on the individuation process. Patricia travels the world giving talks and workshops based on her findings and has a private consulting practice in Chicago. Be informed of new programs and content by joining our mailing list! Support this free podcast by making a donation, becoming a member of the Institute, or making a purchase in our online store! Your support enables us to provide free and low-cost educational resources to all. This podcast is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. You may share it, but please do not change it, sell it, or transcribe it.Executive Producer: Ben LawHosts: Patricia Martin, Judith Cooper, Daniel Ross, Adina Davidson, and Raisa Cabrera2025-2026 Season Intern: Zoe KalawMusic: Peter Demuth

Marriage, Divorce and Fornication (1) (audio) David Eells, 5/24/26   Scriptural Marriage and Divorce David Eells I know this can be a real can of worms and such a touchy subject when dealing with people who love each other, but we owe it to the brethren to speak the truth concerning their eternal life. We must consider scripture rather than human reasoning, which has gotten a lot of people in trouble and they don't know why they are there. Here are some basic things the Lord has shown from scripture on divorce and remarriage: Jesus' commands superseded the Jews' permission for divorce by His statements, so we cannot go to the law to justify divorce. (Mat.19:8) He said to them, Because of your hardness of heart Moses permitted you to divorce your wives; but from the beginning it has not been this way. Once again religion is wrong. Hardened hearts cannot be turned easily but in respecting scripture there is safety. There is only one reason for divorce. (9) And I say to you, whoever divorces his wife, except for fornication (Numeric) and marries another woman commits adultery.” If a spouse commits fornication, whether outside of the first marriage or by illegal remarriage, the other is free to remarry because the first spouse broke the marriage bond. Being legally able to remarry does not mean this is God's will for you. God loves to restore. If your mate repents and asks your forgiveness, then forgive as Christ forgave you. Also, spiritual fornication of the heart is not an excuse, for the scripture speaks of physical fornication of the body. You may be concerned, thinking, “What can I do if I got married before I came to the Lord?” Don't worry about that, because everything we did before we came to the Lord was sin, and we can't go back and do anything about it. After you're saved, you are now a new creation in the Lord, and your sins are washed clean by the blood of Christ. The disciples admitted this was a hard statement, and many think so today, but it is better to obey than to bring yourselves under a curse that many endure. (Mat.19:10) The disciples said to Him, “If the relationship of the man with his wife is like this, it is better not to marry.” Even in the Old Testament, it was fornication for a believer to be married to an unbeliever but hear me out... (Ezr.9:2) For they have taken of their daughters for themselves and for their sons, so that the holy seed have mingled themselves with the peoples of the lands: yea, the hand of the princes and rulers hath been chief in this trespass. ... (Ezr.10:10) And Ezra the priest stood up, and said unto them, Ye have trespassed, and have married foreign women, to increase the guilt of Israel. (11) Now therefore make confession unto Jehovah, the God of your fathers, and do his pleasure; and separate yourselves from the peoples of the land, and from the foreign women. Don't act here without reading on. And so it is in the New Covenant: (1Co.7:39) A wife is bound for so long time as her husband liveth; but if the husband be dead, she is free to be married to whom she will; only in the Lord. Notice we are to marry “only in the Lord”. (1Co.9:5) Have we no right to lead about a wife that is a believer. Notice the condition, the wife must be a believer.. (2Co.6:14) Be not unequally yoked with unbelievers: for what fellowship have righteousness and iniquity? or what communion hath light with darkness? (15) And what concord hath Christ with Belial? or what portion hath a believer with an unbeliever? (If one becomes one with an unbeliever to some extent they are leavening themselves.)(16) And what agreement hath a temple of God with idols? for we are a temple of the living God; even as God said, I will dwell in them, and walk in them; and I will be their God, and they shall be my people. (17) Wherefore Come ye out from among them, and be ye separate, saith the Lord, And touch no unclean thing; And I will receive you. Better not even to date an unbeliever, saints. You don't want to go there because it will bring you a lot of heartache and curses in the future. However, God makes a concession in the New Testament when a person comes to the Lord with an unbelieving spouse because the unbelieving spouse might eventually be saved through their faith. (1Co.7:12) But to the rest say I, not the Lord: If any brother hath an unbelieving wife, and she is content to dwell with him, let him not leave her. (13) And the woman that hath an unbelieving husband, and he is content to dwell with her, let her not leave her husband. (14) For the unbelieving husband is sanctified in the wife, and the unbelieving wife is sanctified in the brother: else were your children unclean; but now are they holy. If that spouse, as an unbeliever, departs, you can remarry. (15) Yet if the unbelieving departeth, let him depart: the brother or the sister is not under bondage in such [cases]... Even if you are remarried illegally many times before coming to the Lord, the commands are to Christians and are not retroactive to the old life, for we are a new creation, cleansed of all past sins. Also, Christians can do things in ignorance that are under the blood, for knowledge precedes sin in the New Testament, as before the Law. (Rom.5:13) for until the law sin was in the world; but sin is not imputed when there is no law. (Rom.7:8)... for apart from the law sin [is] dead. (Jas.4:17) To him therefore that knoweth to do good, and doeth it not, to him it is sin. (Joh.15:22) If I had not come and spoken unto them, they had not had sin: but now they have no excuse for their sin. This is not an excuse for someone to falsely claim ignorance because God looks on the heart and knows all; He knows what you understand and what you do not. Judgment is sure for fornicators and adulterers. (1Co.6:9) Or know ye not that the unrighteous shall not inherit the kingdom of God? Be not deceived: neither fornicators (Basically illegal sexual actions), nor idolaters, nor adulterers (Sometimes this is marrying someone who is already married and not scripturally divorced), nor effeminate, nor abusers of themselves with men, (10) nor thieves, nor covetous, nor drunkards, nor revilers, nor extortioners, shall inherit the kingdom of God. (Rev.21:7) He that overcometh shall inherit these things; and I will be his God, and he shall be my son. (8) But for the fearful, and unbelieving, and abominable, and murderers, and fornicators, and sorcerers, and idolaters, and all liars, their part [shall be] in the lake that burneth with fire and brimstone; which is the second death. Marriage and divorce can be a very convoluted problem. If, after diligently searching into all that the New Covenant teaches on this subject and asking elders with no satisfaction, remember what Moses did. (Exo.18:25) And Moses chose able men out of all Israel, and made them heads over the people, rulers of thousands, rulers of hundreds, rulers of fifties, and rulers of tens. (26) And they judged the people at all seasons: the hard causes they brought unto Moses, but every small matter they judged themselves. God told Moses that he would be as God to Israel. For some things, we need to get a word from our Lord. But be careful that you don't receive a flesh pleasing answer from your own mind. Samson kept choosing women for looks rather than staying with scripture and it got him killed. Let's look at what Paul wrote to the Corinthians about marriage. (1Co.7:1) Now concerning the things whereof ye wrote: It is good for a man not to touch a woman. (2) But, because of fornications, let each man have his own wife, and let each woman have her own husband. (3) Let the husband render unto the wife her due: and likewise also the wife unto the husband. (4) The wife hath not power over her own body, but the husband: and likewise also the husband hath not power over his own body, but the wife. (5) Defraud ye not one the other, except it be by consent for a season, that ye may give yourselves unto prayer, and may be together again, that Satan tempt you not because of your incontinency. (6) But this I say by way of concession, not of commandment. (7) Yet I would that all men were even as I myself. Howbeit each man hath his own gift from God, one after this manner, and another after that. (If you're not married, then you won't be distracted, but not everybody has this gift to be celibate, and we're told, (Pro.18:22) Whoso findeth a wife findeth a good thing, And obtaineth favor of the Lord.) (8) But I say to the unmarried and to widows, It is good for them if they abide even as I. (9) But if they have not continency, let them marry: for it is better to marry than to burn. (10) But unto the married I give charge, [yea] not I, but the Lord, That the wife depart not from her husband (11) (but should she depart, let her remain unmarried, or else be reconciled to her husband); and that the husband leave not his wife.  (I know there are circumstances where a believing or unbelieving husband can be very obnoxious, very overbearing, very sinful, and that's very crucifying to the wife, but that's not an excuse to leave. In most cases, unless he is asking the wife to willfully sin, there can be submission on her part. However, no one should stay in a situation where their life or the lives of their children are in physical danger. We have permission in such a case to flee (Matthew 24:16; Luke 21:21; etc.). (12) But to the rest say I, not the Lord: If any brother hath an unbelieving wife, and she is content to dwell with him, let him not leave her. (13) And the woman that hath an unbelieving husband, and he is content to dwell with her, let her not leave her husband. (14) For the unbelieving husband is sanctified in the wife, and the unbelieving wife is sanctified in the brother: else were your children unclean; but now are they holy. Sanctified here means that the influence of you Christian life can save them and also your faith can stand in for them. (15) Yet if the unbelieving departeth, let him depart: the brother or the sister is not under bondage in such [cases]: but God hath called us in peace. (Just know that in the New Testament, being married to an unbeliever is not grounds to leave them; again, only if they leave you, are you free. In the Old Testament, however, if a believer married a non-believer, they demanded a divorce over that because for Jews to be married to non-Jews was fornication (Nehemiah 13:23-30; Ezra chapters 9 and 10). (Neh.13:26) Did not Solomon king of Israel sin by these things? yet among many nations was there no king like him, and he was beloved of his God, and God made him king over all Israel: nevertheless even him did foreign women cause to sin. (27) Shall we then hearken unto you to do all this great evil, to trespass against our God in marrying foreign women? Back to (1Cor.7:16) For how knowest thou, O wife, whether thou shalt save thy husband? Or how knowest thou, O husband, whether thou shalt save thy wife? …(25) Now concerning virgins I have no commandment of the Lord: but I give my judgment, as one that hath obtained mercy of the Lord to be trustworthy. (26) I think therefore that this is good by reason of the distress that is upon us, [namely,] that it is good for a man to be as he is. (27) Art thou bound unto a wife? Seek not to be loosed. Art thou loosed from a wife? Seek not a wife. (28) But shouldest thou marry, thou hast not sinned; and if a virgin marry, she hath not sinned. Yet such shall have tribulation in the flesh: and I would spare you. (29) But this I say, brethren, the time is shortened, that henceforth both those that have wives may be as though they had none; (In other words don't let this distract from your service to God.) (30) and those that weep, as though they wept not; and those that rejoice, as though they rejoiced not; and those that buy, as though they possessed not; (31) and those that use the world, as not using it to the full: for the fashion of this world passeth away. (32) But I would have you to be free from cares. He that is unmarried is careful for the things of the Lord, how he may please the Lord; (In other words, they're not divided in their attention. However, people don't have to be divided in their attention; they can be celibate or they can always put the Lord first.) (33) but he that is married is careful for the things of the world, how he may please his wife, (Well, if a man is married, it's necessary for him to please his wife, but not to the extent that he lets her be the head of the house; that's bad, very bad. That's like Jezebel and Ahab  and I'll share more on that later.) (34) and is divided. [So] also the woman that is unmarried and the virgin is careful for the things of the Lord, that she may be holy both in body and in spirit: but she that is married is careful for the things of the world, how she may please her husband. (Is this a bad thing? No, it's commanded, as a matter of fact. It's not a bad thing; it's just that your ability to have your total attention on the Lord without being distracted by family situations is going to be limited. God created the family, so He's not against families. He's against families where they're not married, obviously. What Paul is saying is that if a woman is married, she has to please her husband.) (35) And this I say for your own profit; not that I may cast a snare upon you, but for that which is seemly, and that ye may attend upon the Lord without distraction. (36) But if any man thinketh that he behaveth himself unseemly toward his virgin [daughter], if she be past the flower of her age, and if need so requireth, let him do what he will; he sinneth not; let them marry. (You have to understand that a woman was under the authority of her father until she married.)(37) But he that standeth stedfast in his heart, having no necessity, but hath power as touching in his own heart, to keep his own virgin [daughter], shall do well. (38) So then both he that giveth his own virgin [daughter] in marriage doeth well; and he that giveth her not in marriage shall do better. (39) A wife is bound for so long time as her husband liveth; but if the husband be dead, she is free to be married to whom she will; only in the Lord. (40) But she is happier if she abide as she is, after my judgment: and I think that I also have the Spirit of God.   Polygamy in the Church? Question from a sister: Someone told me that polygamy is allowed by God! I don't believe this, but I had no way to refute this claim. I tried finding some scriptures, but to no avail. When I looked this subject up on the internet, I actually found a “Christian” website promoting polygamy. What will they think of next? Can you share some scriptures that refute this claim? My answer: Under the Law, they were permitted to have more than one wife and divorce their wives because of their “hardness of heart” but under grace, there is no such permission. Jesus said a man could have one wife and “the two shall become one flesh.” (Mat.19:5-8) and said, For this cause shall a man leave his father and mother, and shall cleave to his wife; and the two shall become one flesh? So that they are no more two, but one flesh. What therefore God hath joined together, let not man put asunder. They say unto him, Why then did Moses command to give a bill of divorcement, and to put [her] away? He saith unto them, Moses for your hardness of heart suffered you to put away your wives: but from the beginning it hath not been so. From the beginning, God gave Adam, the Son of God, one wife. It appears his righteous seed through Seth were monogamous also. Cain's evil descendant, Lamech, was the first to take two wives. (Gen.4:19) And Lamech took unto him two wives. In order that a line of Israel not be extinct, the next of kin was permitted to raise up seed to a dead man's wife. But the seed of New Testament spiritual Israel is passed on through the Word (seed or sperma) of God. That which is born of the flesh is flesh, and that which is born of the spirit is spirit. Although they disobeyed God, the Kings of Israel were forbidden to multiply wives. (Deu.17:17-19) Neither shall he multiply wives to himself, that his heart turn not away: neither shall he greatly multiply to himself silver and gold. And it shall be, when he sitteth upon the throne of his kingdom, that he shall write him a copy of this law in a book, out of [that which is] before the priests the Levites: and it shall be with him, and he shall read therein all the days of his life; that he may learn to fear Jehovah his God, to keep all the words of this law and these statutes, to do them. The Apostles had one wife. (1Co.9:5) Have we no right to lead about a wife that is a believer, even as the rest of the apostles, and the brethren of the Lord, and Cephas? All of God's people must be upright, but Paul required elders to be “without reproach” and “blameless” in that they were to be the “husband of one wife.” This is definitely one wife at a time because fornication is a legal ground for divorce and remarriage (1 Corinthians 7), and the death of a spouse is a legal ground to remarry. (1Ti.3:2) The bishop therefore must be without reproach, the husband of one wife, temperate, sober-minded, orderly, given to hospitality, apt to teach. (12) Let deacons be husbands of one wife, ruling [their] children and their own houses well. (Tit.1:6,7) if any man is blameless, the husband of one wife, having children that believe, who are not accused of riot or unruly. For the bishop must be blameless, as God's steward... If the elders or the mature in the Lord need to be upright in having one wife, all need to be this way to be mature. The husband is the head of one wife as Christ is the head of one church. (Eph.5:23-33) For the husband is the head of the wife (not wives), as Christ also is the head of the church, [being] himself the saviour of the body. (24) But as the church is subject to Christ, so [let] the wives also [be] to their husbands in everything. (25) Husbands, love your wives, even as Christ also loved the church, and gave himself up for it; (26) that he might sanctify it, having cleansed it by the washing of water with the word, (27) that he might present the church to himself a glorious [church], not having spot or wrinkle or any such thing; but that it should be holy and without blemish. (28) Even so ought husbands also to love their own wives as their own bodies. He that loveth his own wife loveth himself: (29) for no man ever hated his own flesh; but nourisheth and cherisheth it, even as Christ also the church; (30) because we are members of his body. (31) For this cause shall a man leave his father and mother, and shall cleave to his wife (not wives); and the two shall become one flesh. (32) This mystery is great: but I speak in regard of Christ and of the church. (33) Nevertheless do ye also severally love each one his own wife even as himself; and [let] the wife [see] that she fear her husband. Now, I want to share this, too. Men, do not appease a Jezebel spirit; it's going to seduce you and lead you astray. This is our command from God. (Eph.5:22) Wives, [be in subjection] unto your own husbands, as unto the Lord. (The Lord, not I, said this, but those who have a Jezebel spirit will still get angry, although this is the truth. We have to obey God's Word, or we can't call ourselves “disciples.”) (23) For the husband is the head of the wife, as Christ also is the head of the church, (Just as much as Jesus is Head of the Church, the husband is the head of the wife.), [being] himself the saviour of the body. (If a wife does not obey her husband, she is not going to get saved.) (24) But as the church is subject to Christ, so [let] the wives also [be] to their husbands in everything. (To make this possible for the wife, we are then told,) (25) Husbands, love your wives (Feeling unloved isn't an excuse for a wife to disobey her husband, but love makes it easier for the wife to obey her husband.), even as Christ also loved the church, and gave himself up for it. Men, loving your wife does not include giving in to a Jezebel spirit. Giving in means you are putting yourself under a demon spirit and taking yourself and your family out from under God. If you do that, you will pay the price. On the other hand, do not judge the lost wife. God insists on Christ the Word being your Head. Don't judge her, but don't allow her to be your Head. If Jesus is not your Head, then you are following a false god. It's very plain. (Mat.12:30) He that is not with me is against me… If, because of your stand for Christ, your wife leaves you, then suffer for Christ's sake. We all have to suffer in one way or another, but do not follow a false god. The Bible says, (1Co.7:15) Yet if the unbelieving departeth, let him depart: the brother or the sister is not under bondage in such [cases:] but God hath called us in peace If your spouse leaves because you follow Jesus, then so be it. You are not bound in such a case; God never really wants you to be married to an unbeliever anyway. He says to stay married to them only if they are content to dwell with you, because they can be saved through your witness. Amen! The wife who has an unbelieving husband should obey him up to, but not including, moral sin. (1Pe.3:1) In like manner, ye wives, [be] in subjection to your own husbands; that, even if any obey not the word, they may without the word be gained by the behavior of their wives. (Read our book on our site, Word Woman and Authority.) If you want to be a disciple of Jesus, you have to follow the Word. If you want to be a “Christian” and not be a disciple of Jesus, you are not going to be saved. It's that simple. The word “Christian” is a very loose term in our day, meaning almost nothing. In the early days, people were called “Christians” because they followed Christ Jesus and did His works. Today, the word “Christian” should mean more, but, sadly, it doesn't mean much to people. Jesus told us, (Mat.10:34) Think not that I came to send peace on the earth (You might think, “Peace between me and my wife is the most important. I have to do whatever I have to do.” No, you don't. Jesus did not come to send peace on the earth.): I came not to send peace, but a sword. (And that “sword” is to divide those who are loyal to God's Word from those who are not.) (35) For I came to set a man at variance against his father, and the daughter against her mother, and the daughter in law against her mother in law (Now, there are many more relationships. He's just making a point.): (36) and a man's foes [shall be] they of his own household. When you come to God, and they have not, you have no communion there. The Bible says, (2Co.6:14) Be not unequally yoked with unbelievers: for what fellowship have righteousness and iniquity? or what communion hath light with darkness? If you follow the Lord, they can be converted by your witness. If you don't follow the Lord, you have no favor from God, and in that event, don't expect your family to be saved. For your family to be saved, the most important thing for you to do is follow the Lord as a disciple of Jesus Christ and have favor from God. He will save your family if you believe Him for it. (Mat.10:37) He that loveth father or mother more than me is not worthy of me; and he that loveth son or daughter more than me is not worthy of me. You can love people more than you love the Word. The Lord and Word are the same. If you love someone or something more than the Word, you are going to be deceived. It's possible to pity demon-possessed people and then, through demons manipulating that pity, to be deceived and fall right into their situation. Don't believe that all those who call themselves “Christian” are going to be saved, because (Mat.10:38) And he that doth not take his cross and follow after me, is not worthy of me. (We are to die on our “cross” in order to gain our higher life, the life of the born-again man.) (39) He that findeth his life (This is the old psuche life.) shall lose it; (39) and he that loseth his life (Again, this is the old psuche life, the carnal self.) for my sake shall find it. Let me share with you a testimony we have on our site called:   Marriage Lost and Found William and Jamie Leek - 02/09/2010 My wife and I have been separated and near divorce twice since the year 2000 because we loved “our sin”, plain and simple. The first separation was in 2002 and 2003. This separation wasn't as bad as the second, but there were a lot of lies and deceit practiced by both parties during the first separation. We got back together in 2003, where our “Mother in the Lord” renewed our vows. The only problem with this is that we were still mocking God in our walks with Him and still “playing church.” We had made a “confession” of Jesus Christ, but we were not being taught the “whole counsel of God,” so we thought the Lord forgave our sin at the cross, and we were “Covered in the Blood.” According to Matthew 12:43-45, when we confessed Christ and His blood cleansed us from our sin and the curse, we allowed that sin to remain in our lives. The demons, which plagued us, brought seven more back with them, stronger than the first. Thus, we were worse off than ever before. We thank the Lord for His mercy, grace, and long-suffering with us. In 2004 came the second separation. This time, the Lord had given us both over to the desires of our very own wicked hearts and allowed us to sink to levels of darkness that we never knew we had in us. During our second separation, the Lord allowed us to see just how sick the human heart, will, and emotions really are (Jeremiah 17:9). During this time of separation, we both fled at top speed back into the world, and we returned to our old ways. I began to smoke pot again (all day EVERYDAY), and she began to drink more than she ever did. We both began to sleep around with other people outside of our marriage. We were separated for nine months, and the combined number of people the two of us slept with was 16. The Lord really allowed us to fall to the bottom of the depths of the sea of sin, which our lives had become. We were going to a little Pentecostal church at the time when these separations took place. It was here we met a woman I considered to be like a mother in the Lord. She loved my wife and family with all her heart. She took time to come to our home and share the scriptures with us once a week for an extended period of time. She believed with her whole heart that we were “called” to the ministry. She would call me in the middle of the night and say, “I woke up in tears, praying in tongues because I just had such a burden for your family.” The Lord would end up using this mighty woman of God and her fervent prayer life to reconcile our marriage and heal our family. She also told me during the 2004 separation that the Lord gave her a dream where He showed her my family living together in a home happier than we had ever been. This, of course, did not matter to me at the time because my heart was full of rage and hatred. I don't believe in accidents; I believe in the sovereign God written about in the scriptures. In January of 2005, I took a trip to Florida with a woman with whom I had been committing adultery. We drove down together, but for some reason at the end of the trip I made her get on a plane, and I drove home alone. On the trip home, my wife and I started to talk again. The Lord also began to really convict me of my sin. Even though, at the time, I did not understand the meaning of “conviction of sin.” All I knew was that I had an overwhelming feeling of guilt for what I was doing. I knew that a change had to come. In April of 2005, my wife and I really started to talk again on a regular basis. At the beginning of May, we had been together for the entire weekend when we received a phone call from a lady with whom we had gone to church. This lady had news that would shake my wife and me to the very core of our being. She told me that my Mother in the Lord, Shirley Summers, was dying of cancer. Well, this is where we know the Lord began to heal our marriage. When the woman shared this news with me on the phone, I began to weep. With tears streaming down my face, I shared the news with my wife, and we shared tears together. She looked at me and said, “I am going to my parents' house, and I'm getting my things, and I am coming home.” That was on May 4, 2005. The next day, my mom called me on the phone and told me that Shirley had gone on to glory. The reason this stands out as one of the most important events in our marriage is that this woman prayed for us fervently (James 5:16). She never stopped believing in our call to the ministry, and she stood in faith for our marriage when we couldn't. Also, the number “5” in the scriptures signifies “GRACE,” and we didn't realize that until a year later, that our Mother in the Lord had died on 5/05/05, a number and day of GRACE. The Lord was very long-suffering with my wife and me. It was not until after we reconciled that we ran across a website where we began to hear the “full Gospel” being preached. We had never heard all the important doctrines taught throughout the scriptures. We had not been taught about repentance, obedience, holiness, or real Bible faith. We also realized that neither one of us was truly saved, as spoken of in the Bible. The scariest thing of all is that we realized that if the Lord would have called our numbers, we would have gone to HELL! It has been a long journey for both of us, as we got rid of the leaven in our lives after leaving the organized church. Over the years, we have had to learn what it means to repent and to truly come to the Lord, believing who He is and that He rewards those who diligently seek Him. We thank the Lord for UBM for standing for the “TRUE GOSPEL”! Deuteronomy 4:30 When you are in tribulation, and all these things come upon you in the latter days, you will return to the Lord your God and obey his voice. Matthew 3:3 For this is he that was spoken of by the prophet Esaias, saying, The voice of one crying in the wilderness, Prepare ye the way of the Lord, make his paths straight. Now, what about common law marriage? Is that biblical? Most states in America have abolished common law marriage, and only a few states recognize it as a legal marriage between two people who have not purchased a marriage license or had their marriage solemnized by a ceremony. The few states that do recognize it have conditional statutes. Scripture is clear that marriage is a binding commitment before witnesses and God; a public, covenantal relationship. It is a commitment agreement until death. When Christians marry, they commit to loving each other just as Christ loved the church. If you are not married, you are living in fornication.   Heterosexual and Homosexual Fornication Letter from a friend:  Hi! I have a neighbor friend with whom I've been having sort of an ongoing “discussion/argument” about whether sex outside of marriage is OK, according to the Bible. I know in my heart it is not, but he wants me to prove it to him with scripture. I haven't studied it extensively, but what I've read doesn't say it precisely enough to prove my point. There is one passage about two unwed people being found in the act and having to marry. Since the Ten Commandments do not say, thou shalt not have sex outside of marriage, he thinks it is ok. (LOL) Of course, the real issue is that he's not a born-again believer. But he asked me to prove it to him, so I'm going to try to do it. I don't know much about the Hebrew meanings of the words, etc. Can you help when you have time? :-) Thanks! My reply:  Fornication is the broad term that covers all sex outside of heterosexual marriage. Adultery, homosexuality, whoremonger, bestiality, and masturbation all fall under this category. The Greek word for fornication is “porneia”, from which we get pornography. Many commit fornication with pornography in print or on any visual screen, TV, social media sites, movies, etc. (Mat.5:28) but I say unto you, that every one that looketh on a woman to lust after her hath committed adultery with her already in his heart. The same is true for any other illicit sexual desire. Repentance and faith deliver from these sins.   Heterosexual Fornication Everyone who has sex out of marriage is a fornicator. (1Co.7:1) Now concerning the things whereof ye wrote: It is good for a man not to touch a woman. (7:2) But, because of fornications, let each man have his own wife, and let each woman have her own husband. All fornicators must repent or face eternal damnation. (1Co.6:9) Or know ye not that the unrighteous shall not inherit the kingdom of God? Be not deceived: neither fornicators, nor idolaters, nor adulterers, nor effeminate, nor abusers of themselves with men, (10) nor thieves, nor covetous, nor drunkards, nor revilers, nor extortioners, shall inherit the kingdom of God. (11) And such were some of you: but ye were washed, but ye were sanctified, but ye were justified in the name of the Lord Jesus Christ, and in the Spirit of our God. (15) Know ye not that your bodies are members of Christ? shall I then take away the members of Christ, and make them members of a harlot? God forbid. (16) Or know ye not that he that is joined to a harlot is one body? for, The twain, saith he, shall become one flesh. (17) But he that is joined unto the Lord is one spirit. (18) Flee fornication. Every sin that a man doeth is without the body; but he that committeth fornication sinneth against his own body. (1Co.10:8) Neither let us commit fornication, as some of them committed, and fell in one day three and twenty thousand. (Gal.5:19) Now the works of the flesh are manifest, which are [these]: fornication, uncleanness, lasciviousness (License to “go beyond the things that are written”), (21) envyings, drunkenness, revellings, and such like; of which I forewarn you, even as I did forewarn you, that they who practise such things shall not inherit the kingdom of God. (Rev.21:7) He that overcometh shall inherit these things; and I will be his God, and he shall be my son. (8) But for the fearful, and unbelieving, and abominable, and murderers, and fornicators, and sorcerers, and idolaters, and all liars, their part [shall be] in the lake that burneth with fire and brimstone; which is the second death. (Rev.22:14) Blessed are they that wash their robes, that they may have the right [to come] to the tree of life, and my enter in by the gates into the city (the bride). (15) Without are the dogs, and the sorcerers, and the fornicators, and the murderers, and the idolaters, and every one that loveth and maketh a lie. (1Co.7:9) But if they have not continency (self-control of sexual appetites), let them marry: for it is better to marry than to burn. (1Ti.5:14) I desire therefore that the younger [widows] marry, bear children, rule the household, give no occasion to the adversary for reviling: (15) for already some are turned aside after Satan. (Job.31:1) I made a covenant with mine eyes; How then should I look upon a virgin? (9) If my heart hath been enticed unto a woman, And I have laid wait at my neighbor's door; (10) Then let my wife grind unto another, And let others bow down upon her. (11) For that were a heinous crime; Yea, it were an iniquity to be punished by the judges: (12) For it is a fire that consumeth unto Destruction, And would root out all mine increase. (Pro.2:16) To deliver thee from the strange woman, Even from the foreigner that flattereth with her words; (17) That forsaketh the friend of her youth, And forgetteth the covenant of her God: (18) For her house inclineth unto death, And her paths unto the dead; (19) None that go unto her return again, Neither do they attain unto the paths of life: (Exo.22:16) And if a man entice a virgin that is not betrothed, and lie with her, he shall surely pay a dowry for her to be his wife. (17) If her father utterly refuse to give her unto him, he shall pay money according to the dowry of virgins. (Deu.22:28) If a man find a damsel that is a virgin, that is not betrothed, and lay hold on her, and lie with her, and they be found; (29) then the man that lay with her shall give unto the damsel's father fifty [shekels] of silver, and she shall be his wife, because he hath humbled her; he may not put her away all his days. Do you believe that because you are “saved” that you can get away with this willful disobedience? (Jer.7:9) Will ye steal, murder, and commit adultery, and swear falsely, and burn incense unto Baal, and walk after other gods that ye have not known, (10) and come and stand before me in this house, which is called by my name, and say, We are delivered; that ye may do all these abominations? (11) Is this house, which is called by my name, become a den of robbers in your eyes? Behold, I, even I, have seen it, saith Jehovah. (12) But go ye now unto my place which was in Shiloh, where I caused my name to dwell at the first, and see what I did to it for the wickedness of my people Israel. (13) And now, because ye have done all these works, saith Jehovah, and I spake unto you, rising up early and speaking, but ye heard not; and I called you, but ye answered not: (14) therefore will I do unto the house which is called by my name, wherein ye trust, and unto the place which I gave to you and to your fathers, as I did to Shiloh. (15) And I will cast you out of my sight, as I have cast out all your brethren, even the whole seed of Ephraim. That is just the Old Testament, you say? In any place that we are willfully disobedient, we need the fear of God. Sins of ignorance (Rom.5:13; 7:8,9) and sins of failure (Rom.7:19-25) are under the blood when we repent. However, we cannot claim the sacrificial benefits if we willfully walk in premeditated sin. (Heb.10:26) For if we sin willfully after that we have received the knowledge of the truth, there remaineth no more a sacrifice for sins, (27) but a certain fearful expectation of judgment... Jesus bore all sin; He also bore the penalty for all sin, except willful disobedience. Notice that there is “no more a sacrifice” for that sin. We would have “a certain fearful expectation of judgment.” Many of us have been lied to about the cleansing of the blood. (1Jn.1:7) But if we walk in the light, as he is in the light, we have fellowship one with another, and the blood of Jesus his Son cleanseth us from all sin. The blood cleanses the one who walks in the light of the Word, not in the darkness of willful disobedience. For willful disobedience, we are promised certain judgment. We pay the penalty for this sin here and now, as in the following verses: (Mat.18:34) And his lord was wroth, and delivered him to the tormentors (demons), till he should pay all that was due. (35) So shall also my heavenly Father do unto you, if ye forgive not every one his brother from your hearts. God will use the demons to make us pay for a sin of the will. (Mat.5:25) Agree with thine adversary quickly, while thou art with him in the way; lest haply the adversary deliver thee to the judge (God), and the judge deliver thee to the officer (demon), and thou be cast into prison. (26) Verily I say unto thee, thou shalt by no means come out thence, till thou have paid the last farthing. The prison here is spiritual bondage to sin and the curse, administered by the demons. Jesus came “...to proclaim liberty to the captives, and the opening [of the prison] to them that are bound” (Isa.61:1). Willful disobedience throws us back into the prison that Jesus delivered us from. David sinned willfully with Bathsheba. When he repented, Nathan the prophet said, “The Lord also hath put away thy sin”, but he also said, “The sword shall never depart from thy house.” In other words, I forgive you, but you will have to pay the penalty. This proved true, for David lost three sons and many people. His own son Absalom won the sympathy of the people and usurped the kingdom. David had to flee for his life. As parents we do not spank our children for failure or mistakes, but for willful disobedience. Paul said, “For the good which I would I do not: but the evil which I would not (willed not), that I practice. But if what I would not (willed not), that I do, it is no more I that do it, but sin which dwelleth in me” (Rom.7:19,20). Paul was failing God in a sin that his will was against. Notice that he hated the sin and was not accounted guilty; the old sin nature was guilty. When we are against the sin, God takes our side against the sin. He takes the side of the spiritual man against the old man. In this state, Paul cried out to the Lord. (24) Wretched man that I am! who shall deliver me out of the body of this death? Then he accepted God's promise of deliverance by faith. (25) I thank God through Jesus Christ our Lord. Jesus bore the curse of the sin for a person who, like Paul, is repentant. The curse of death is upon the one who will not save themselves for marriage. (Deu.22:13) If any man take a wife, and go in unto her, and hate her,(14) and lay shameful things to her charge, and bring up an evil name upon her, and say, I took this woman, and when I came nigh to her, I found not in her the tokens of virginity; …(20) But if this thing be true, that the tokens of virginity were not found in the damsel; (21) then they shall bring out the damsel to the door of her father's house, and the men of her city shall stone her to death with stones, because she hath wrought folly in Israel, to play the harlot in her father's house: so shalt thou put away the evil from the midst of thee. Only repentance and faith in the sacrifice of Jesus removes this curse. (22) If a man be found lying with a woman married to a husband,(Adultery) then they shall both of them die, the man that lay with the woman, and the woman: so shalt thou put away the evil from Israel. (23) If there be a damsel that is a virgin betrothed unto a husband, and a man find her in the city, and lie with her; (24) then ye shall bring them both out unto the gate of that city, and ye shall stone them to death with stones; the damsel, because she cried not, being in the city; and the man, because he hath humbled his neighbor's wife: so thou shalt put away the evil from the midst of thee. (25) But if the man find the damsel that is betrothed in the field, and the man force her, and lie with her; then the man only that lay with her shall die: (26) but unto the damsel thou shalt do nothing; there is in the damsel no sin worthy of death: for as when a man riseth against his neighbor, and slayeth him, even so is this matter; (27) for he found her in the field, the betrothed damsel cried, and there was none to save her.   Homosexual Fornication (Jude 1:7) Even as Sodom and Gomorrah, and the cities about them, having in like manner with these given themselves over to fornication and gone after strange flesh (Men with men/women with women), are set forth as an example, suffering the punishment of eternal fire. (2Pe.2:6) and turning the cities of Sodom and Gomorrah into ashes condemned them with an overthrow, having made them an example unto those that should live ungodly; (7) and delivered righteous Lot, sore distressed by the lascivious life of the wicked (8) (for that righteous man dwelling among them, in seeing and hearing, vexed [his] righteous soul from day to day with [their] lawless deeds): (9) the Lord knoweth how to deliver the godly out of temptation, and to keep the unrighteous under punishment unto the day of judgment; (10) but chiefly them that walk after the flesh in the lust of defilement, and despise dominion. We have seen many people who fell into faction and ultimately into fornication of many kinds, and God reprobated them. Let me share a portion of a dream from Reynaldo Portela: In this dream, an angel put me in a room where a group of men was practicing homosexuality, and the angel told me, “The man who has sex with another man is going to regret it. God hates the practice of that sin.” (David: In the spiritual, we are reborn with Christ's spirit. Therefore, we should only sow Christ's spirit in our soul, which is our mind, will, and emotions. If we receive the spiritual seed of “men”, we often lose our first love and become reprobate.) (Rom.1:24) Wherefore God gave them up in the lusts of their hearts unto uncleanness, that their bodies should be dishonored among themselves: (25) for that they exchanged the truth of God for a lie, and worshipped and served the creature rather than the Creator, who is blessed for ever. Amen. (26) For this cause God gave them up unto vile passions: for their women changed the natural use into that which is against nature: (27) and likewise also the men, leaving the natural use of the woman, burned in their lust one toward another, men with men working unseemliness, and receiving in themselves that recompense of their error which was due. (28) And even as they refused to have God in [their] knowledge, God gave them up unto a reprobate mind, to do those things which are not fitting (32) who, knowing the ordinance of God, that they that practise such things are worthy of death, not only do the same, but also consent with them that practise them. In an open vision, I, David, saw a factious group, and one of them that I knew left them and went behind a wall. The Lord said, “Follow him,” so I did. What I saw behind the wall was this man committing sodomy on 3 of his friends. Over the next day or two, I went to this man and told him my vision, and his eyes widened, and Michael and I both saw he was guilty. He didn't deny it, but later he threatened me. The factious leader told me about three times that he spoke with them during a certain time period, when he was supposed to be with us, and then he fell away three times. I told him he could not associate with them according to the Word. Eve Brast had a dream where they had captured her, and they were bisexual. Other factious leaders had the same problem and were also bisexual. They all have sexual perversion. Satan demands perversion from his servants. The DS are satanists also and are bisexual. They have the same spirits. God is always willing to deliver anyone like this if there is repentance. (Gal.5:19) Now the works of the flesh are manifest, which are [these]: fornication, uncleanness, lasciviousness, (21) ...they who practise such things shall not inherit the kingdom of God. (1Co.6:9) Or know ye not that the unrighteous shall not inherit the kingdom of God? Be not deceived: neither fornicators, nor idolaters, nor adulterers, nor effeminate, nor abusers of themselves with men, (10) ... shall inherit the kingdom of God. (11) And such were some of you: but ye were washed, but ye were sanctified, but ye were justified in the name of the Lord Jesus Christ, and in the Spirit of our God. (Deu.23:17) There shall be no prostitute of the daughters of Israel, neither shall there be a sodomite of the sons of Israel. (18) Thou shalt not bring the hire of a harlot, or the wages of a dog, into the house of Jehovah thy God for any vow: for even both these are an abomination unto Jehovah thy God. (Rev.21:7) He that overcometh shall inherit these things; and I will be his God, and he shall be my son. (8) But for the fearful, and unbelieving, and abominable, and murderers, and fornicators, and sorcerers, and idolaters, and all liars, their part [shall be] in the lake that burneth with fire and brimstone; which is the second death. (Rev.22:14) Blessed are they that wash their robes, that they may have the right [to come] to the tree of life, and my enter in by the gates into the city. (15) Without are the dogs, and the sorcerers, and the fornicators, and the murderers, and the idolaters, and every one that loveth and maketh a lie. Sodomite Crossdressers -(1Ki.14:24) and there were also sodomites in the land: they did according to all the abominations of the nations which Jehovah drove out before the children of Israel. (1Ki.15:11) And Asa did that which was right in the eyes of Jehovah, as did David his father. (12) And he put away the sodomites out of the land, and removed all the idols that his fathers had made. (Deu.22:5) A woman shall not wear that which pertaineth unto a man, neither shall a man put on a woman's garment; for whosoever doeth these things is an abomination unto Jehovah thy God. (Lev.18:22) Thou shalt not lie with mankind, as with womankind: it is abomination. (Lev.20:13) And if a man lie with mankind, as with womankind, both of them have committed abomination: they shall surely be put to death; their blood shall be upon them.   Bestiality (Exo.22:19) Whosoever lieth with a beast shall surely be put to death. (Lev.18:23) And thou shalt not lie with any beast to defile thyself therewith; neither shall any woman stand before a beast, to lie down thereto: it is confusion. (Lev.20:15) And if a man lie with a beast, he shall surely be put to death: and ye shall slay the beast. (16) And if a woman approach unto any beast, and lie down thereto, thou shalt kill the woman, and the beast: they shall surely be put to death; their blood shall be upon them. (Deu.27:21) Cursed be he that lieth with any manner of beast. And all the people shall say, Amen.   Masturbation (Gen.38:8) And Judah said unto Onan, Go in unto thy brother's wife, and perform the duty of a husband's brother unto her, and raise up seed to thy brother. (9) And Onan knew that the seed would not be his; and it came to pass, when he went in unto his brother's wife, that he spilled it on the ground, lest he should give seed to his brother. (10) And the thing which he did was evil in the sight of Jehovah: and he slew him also. Remember I said that through repentance and faith in Jesus and His sacrifice for us, there is deliverance from these sins and its curses. Now God knows that you did not necessarily choose this life, and some of you think you had this from birth, which is not true. A lot of you already know that you were molested at some point in your life, and you became a sinner. Well, these demons entered in then. Now the Good News of the Gospel is that Jesus Christ bore this sin upon Himself for you, and He is offering you grace to repent and be delivered from it so you will never have these wrong desires and emotions again. He took away the sin nature of homosexuality and any sin of fornication. He wants you to repent and surrender your life to Him. Confess your sins as the Bible says in 1Jo.1:9 If we confess our sins, he is faithful and righteous to forgive us our sins, and to cleanse us from all unrighteousness. God will give you a new, clean spirit and a new nature, this free gift of His salvation! Let's pray. Father, we thank You, and we ask You, Lord, to reach out and touch the people out there who are in bondage to sin, homosexual, heterosexual, or any kind of sin, and we ask You, Lord, to reach out and touch them with Your convicting power. Father, we ask You to show them that Your word is true. We ask You to reveal Yourself to them, and to show them the Real True Good News that Jesus has already delivered them from this; He's already borne their sin on the cross, and they don't have to bear it any longer. Father, we ask it in the name of Jesus that You go forth right now and deliver those who are listening to us who believe what's been shared here. Please, Lord, go forth and deliver them now in the name of Jesus. We rebuke these demons from your life in the name of Jesus Christ! O Lord, we thank You for Your mighty power going forth to restore those that You have loved from the foundation of the world. Thank you, Father.  Now, friends, if you agreed and prayed this with us, you need to go and start reading your New Testament and believe what it says and know that the Lord is working in you both to will and do of His good pleasure. It's not by your works, it's His working in you! Now, I want to share a published article on a study done that proves there is freedom from homosexuality.   'Groundbreaking' study shows 'gays' can change  Posted: September 15, 2007 1:00 a.m. Eastern © 2007 WorldNetDaily.com In the first longitudinal, peer-reviewed, scientific study of its kind, researchers have concluded that some homosexuals can change their “orientation” through religiously mediated guidance. Researchers Stanton L. Jones and Mark A. Yarhouse released the results of a three-year study on Thursday during an address at the American Association of Christian Counselors World Conference. Their conclusions contradict the claims of the American Psychological Association and the American Psychiatric Association, which contend that such a change in sexual orientation is impossible and attempting to pursue it likely will cause depression, anxiety, or self-destructive behavior. The new study concluded such changes do not cause psychological harm to the patient. Nicholas A. Cummings, former American Psychological Association president, praised the research. “This study has broken new ground in its adherence to objectivity and a scientific precision that can be replicated and expanded, and it opens new horizons for investigation”, he said. Exodus International, the world's largest Christian ministry to homosexuals, said it funded the research because of the absence of any scientific, peer-reviewed research on the topic. The major findings are reported in a book to be released by the evangelical Christian publisher InterVarsity Press, “Ex-Gays? A Longitudinal Study of Religiously Mediated Change in Sexual Orientation.” A homosexual-activist group called Truth Wins Out warned news organizations “to be highly skeptical of a biased 'ex-gay' sham study.” The homosexual group said, “Caution should be taken in prematurely critiquing the study until the full methodology is available. However, based on unconfirmed reports, there is great concern that these notorious anti-gay researchers did little more than professional ex-gay lobbyists and ministers from Exodus International, and ask them if they had 'changed.'” Alan Chambers, president of Exodus International and a former homosexual, said, “Finally, there is now scientific evidence to prove what we as former homosexuals have known all along - that those who struggle with unwanted same-sex attraction can experience freedom from it.” “For years, opponents of choice have said otherwise, and this body of research is critical in advancing the national dialogue on this issue”, he said. Chambers said, “the life-changing process of leaving homosexuality behind” is not easy, but “for thousands of us, the journey has been well worth it, and we are grateful that these study findings give credence to our existence as men and women whose lives have been transformed by Jesus Christ.” Jones, a provost and professor at Wheaton College, an evangelical school in Wheaton, Ill., told CitizenLink magazine in an interview he was prompted to do the study because of the “ever-increasing pessimism expressed in the professional world that sexual orientation could ever be changed.” “This was in contrast to the fact that I occasionally met individuals in Christian circles who claim to have experienced precisely such change”, he said. “When the mental-health field actually began to say that change is impossible - that sexual orientation cannot be changed - it formed the perfect scientific hypothesis to be able to conduct a study.” Jones noted there have been dozens of studies conducted suggesting change is possible for some people, but “the research is not of the highest quality and has been deeply and highly criticized.” After studying the criticisms of those studies, Jones and Yarhouse concluded the proper methodology would need to be both “prospective and longitudinal.” “Prospective means that you catch people before they begin the change process and follow them through the process, while longitudinal means that you're actually following people over time to see if the change is stable”, Jones explained to CitizenLink. “The scientific characteristics of the study are unique, in that no one has ever started early and then followed people over a long period of time like we did.” Jones said they found that, by following the subjects over time, “not everyone is successful, not even a majority is successful, but a very substantial group of people report fairly dramatic change.” “We found that 15 percent of our sample of about 100 claimed to actually have changed from homosexuality to heterosexuality”, he said. “These people experienced significant enough change that they really felt like they had left one sexual orientation to shift into another.” He acknowledged “life is still complicated for these people, and some still have some residuals of their homosexual attractions.” “However, they are people who report being able to function as heterosexuals, they're happy with their marriages, and they feel that their lives have changed dramatically”, he said. The other type of success he found - in almost a quarter of the subjects - was “people who left the homosexual lifestyle and experienced very substantial reductions in homosexual attraction by embracing the Christian discipline of chastity, not acting on their sexual impulses.” “These were people who felt like they were free now to orient their lives not on their sexual, erotic desires and needs, but on their relationship with God and on healthy, nonsexual intimacy with other people”, Jones said. The two groups together, those who converted and those who experienced chastity, made up about 38 percent of the sample. “We feel these changes observed over this substantial period of time provide a clear indication that the opinions of the secular mental-health field that change is impossible are simply wrong”, Jones said. The second area of the research focused on the secular mental-health community's claims that the attempt to change is harmful. Jones and Yarhouse administered a standard psychological inventory that measures psychological distress to subjects at every point along the way. “We found that there was essentially no change in their psychological distress over time”, Jones said. “On that basis, we feel that there is no evidence that the change attempt is harmful, and we found evidence that change is possible for some people.” He added, however, the research does not prove that anybody can change or that no one has ever been harmed from the attempt to change. “It just suggests that the forceful way in which the secular mental-health community is saying change is impossible and harmful is just not well-advised”, he said. Jones pointed out that the American Psychological Association has a blue-ribbon panel right now examining the question of how it should formulate its policies on the subject of attempts to change sexual orientation. Certain members, Jones noted, have already said publicly that change is impossible and harmful. Jones said he hopes “there will be enough of an open mind on the part of the secular mental-health community that they will not continue the movement towards banning these kinds of attempts to change sexual orientation, harassing them out of existence and labeling as unethical any professional person who cooperates with them.” “There is a need to respect the autonomy of individuals who are distressed about what they have experienced sexually and for religious or moral reasons want to try the attempt to change”, Jones told CitizenLink. “Those people first need to be fully informed about just how complex and difficult that process is, and then they should have the right as individuals, as an exercise of personal and religious freedom, to seek support in their attempt to change sexual orientation.”   Printer-friendly version

By David Stephen who looks at electrochemical psychiatry trends and issues to consider. The College of Psychiatrists of Ireland [CPsychI] and the Royal College of Psychiatrists [RCPsych] may choose to collaborate on one of the major opportunities to better explain mental disorders and addictions: electrochemical psychiatry. The objective is to focus on electrical and chemical signals to describe and display mental disorders and addictions. Already, neuroscience has established that neurons with their electrical and chemical signals are responsible for functions. So, because there has not been any major success in explaining the configurations of mental disorders by neurons — which, in part, may be due do their anatomy as cells — the next options are the electrical and chemical signals. Why CPsychI and RCPsych should partner on electrochemical psychiatry There is currently no national or continental Psychiatric Association that is focused on this. The American Psychiatric Association actually released a road map earlier in 2026, towards improving the Diagnostic and Statistical Manual of Mental Disorders. However, they are having their 2026 Annual Meeting [May 16-20] in San Francisco, with a different theme entirely. Meanwhile, there is a recent debate in the United States about how and when to get off selective serotonin reuptake inhibitors [SSRIs], such that both the people on the side of deprescribing or against it have no model of the human mind, to explore how to map the mind for the effects of medications. While it is true that CPsychI and the RCPsych go it alone, respectively, it is possible to have both of them do much better if they collaborated on getting it done. The American Psychiatric Association do not seem to be in a hurry about solving the mind or have it as a central agenda. This gives the CPsychI and the RCPsych the chance to accelerate and get ahead, to bear the might of global psychiatry and mental health, even as the era evolves with newer risks and more unknowns. The CPsychl also need to make a major mark, giving its relatively young existence as well as the importance to lead right even as guess therapies continue in mental health, with little understanding of how they work. While the RCPsych has the National Collaborating Centre for Mental Health [NCCMH], the principal advance is what can be explained, or displayed using components of the brain, to move certainty to a better percentage, to shape outcomes. This means the interactions and attributes of electrical and chemical signals can be useful to thoroughly move psychiatry forward for now, according to the postulate in Conceptual Biomarkers and Theoretical Biological Factors for Psychiatric and Intelligence Nosology. Conceptually, the human mind is the collection of all the electrical and chemical signals, with their interactions and attributes, in sets, in clusters of neurons, across the central and peripheral nervous systems. Simply, the human mind is the sets of signals. There is a recent [May 14, 2026] analysis in The New York Times, Thinking About Stopping an Antidepressant? Here's What to Consider., stating that, "The American Society of Clinical Psychopharmacology recently published recommendations about "deprescribing" psychiatric medications. They include the suggestion that doctors re-evaluate "the utility of continuing any particular psychotropic medication" on at least an annual basis." "There are several factors to take into account when deciding whether to stop. As a general rule, experts said people could consider going off their antidepressants when they felt they were back to their normal selves." "Dr. Mark Rapaport, the president-elect of the American Psychiatric Association, said he also took into account whether the person had a good support network in place and if they would be experiencing any major life changes in the near future, like moving or starting a new job. "Even good change is associated with stress," he said." "Anoth...

Why are so many people struggling with sugar cravings, binge eating, obesity, and chronic disease — even when they desperately want to stop?In this episode of the Kick Sugar Coach Podcast, we explore the growing scientific movement to recognize ultra-processed food addiction as a legitimate medical condition. Joined by clinical health psychologist Dr. Jen Unwin, we unpack the evidence behind food addiction, why ultra-processed foods may hijack the brain's reward system, and why official recognition could change the future of treatment, research, and recovery.Dr. Jen Unwin shares her personal journey with sugar addiction, her work helping people reverse type 2 diabetes through low-carb and whole-food approaches, and the international effort to have “Ultra-Processed Food Use Disorder” recognized by major medical organizations like the WHO and DSM.

In this special episode of AJP Audio, AJP Editor-in-Chief Dr. Ned Kalin is joined by Dr. María Oquendo (Perelman School of Medicine at the University of Pennsylvania, Philadelphia), chair of APA's Future DSM Strategic Committee to discuss a series of commentaries published in the May issue of the Journal discussing the strategic vision for the future of DSM. 00:39   Oquendo interview 03:07   Size of the response 04:18   Feedback 06:04   Incorporating the feedback 07:57   Emphasizing science with a title change for DSM 10:18   A living document 12:35   Changes from previous versions of DSM 16:08   Changes in documentation and coding 18:51   Lived experience 20:02   Working with AJP Links to the commentaries:  Initial Strategy for the Future of DSMMaría A. Oquendo, M.D., Ph.D., et al. The Future of DSM: A Report From the Structure and Dimensions SubcommitteeDost Öngür, M.D., Ph.D., et al. The Future of DSM: Are Functioning and Quality of Life Essential Elements of a Complete Psychiatric Diagnosis?Karen Drexler, M.D., et al. The Future of DSM: Role of Candidate Biomarkers and Biological FactorsBruce Cuthbert, Ph.D., et al. The Future of DSM: A Strategic Vision for Incorporating Socioeconomic, Cultural, and Environmental Determinants and IntersectionalityMilton L. Wainberg, M.D., et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Dr. Eduardo Butelman (Icahn School of Medicine at Mount Sinai, New York) joins AJP Audio to discuss the varying incidence of psychiatric comorbidities across patients diagnosed with substance use disorders.  Afterwards, AJP Editor-in-Chief Dr. Ned Kalin joins the podcast to discuss the rest of the May issue, which includes a discussion on the future of the DSM. 00:53     Butelman interview 02:23     Mechanisms of difference between males and females 04:04     Patterns of response between males and females in substance use disorders 05:54     Implications for research into sex-based differences 07:33     Racial and ethnic variations in findings 09:30     Limitations 10:46     Immediate clinical implications? 12:09     Further research 13:18     Kalin interview 13:38     Butelman et al. 17:11     Hinojosa et al. 22:49     van Rooij et al. 26:06     The future of DSM Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Get Dr. Vonda's insights Want to understand what's happening in your body — and what to do next? Each week, Dr. Vonda shares science-backed guidance on strength, bone health, muscle, and longevity — the same way she speaks to her patients. Clear. Practical. No noise. Join the newsletter: https://manage.kmail-lists.com/subscriptions/subscribe?a=YqJKtR&g=Ww3gx3   At 89 years old, Dr. Arnold Gilberg still feels 40. That is not a metaphor, it is a philosophy. I sat down with this Beverly Hills psychiatrist, ordained rabbi, and author of The Myth of Aging, trained by one of Sigmund Freud's own colleagues, to talk about the one enemy more dangerous than getting older: disengagement. What we explore:   - How disengagement, not aging itself, is the true driver of physical and mental decline. - Why curiosity is the master key to staying mentally alive as you grow older. - How self-forgiveness unlocks behavioral change that willpower alone never can. - Why psychiatry's drift toward medication alone is leaving patients behind. - Why gratitude, practiced daily, is one of the most powerful tools for vitality. - How giving yourself grace, not perfection, finally allows people to act on what they know. - What happiness really looks like across a lifetime, and why expecting constant joy backfires. - Why vulnerability between doctor and patient, not clinical distance, is what heals. About Dr. Arnold Gilberg: Arnold L. Gilberg, MD, PhD, received his bachelor's degree in political science and Doctor of Medicine degree from the University of Illinois. He interned at the Los Angeles General Medical Center. He is the last person alive trained by Franz Alexander, MD, a distinguished colleague of Sigmund Freud. His psychiatric training took place at the Cedars-Sinai Medical Center, where he was chief psychiatric resident. He also has a doctorate in psychoanalysis from the Southern California Psychoanalytic Institute.    Dr. Gilberg is a Distinguished Life Fellow of the American Psychiatric Association, the former Clinical Chief of Psychiatry at Cedars-Sinai Medical Center in Los Angeles, and an associate clinical professor at UCLA School of Medicine (honorary). He served for ten years under three different governors on the Medical Board of California for LA County, and has treated thousands of patients in his Los Angeles-based practice.

Ein letzter Gruß von Atze und Leon! Nachts wach: Eine Sorge wird abgelöst von der nächsten und begleitet von dem Gefühl, komplett die Kontrolle über die Gedanken verloren zu haben – wer kennt das nicht? Heute reden Atze und Leon über genau dieses Phänomen. Es geht in die zweite Folge zum Thema Sorgen. Dabei beantworten sie die Frage, wieso Sorgen so unkontrollierbar sein können und was ihnen Positives abzugewinnen ist. Von spannenden Theorien, was die Sorgen aufrechterhält, über einen Exkurs in die generalisierte Angststörung gibt es in dieser Folge viele praktische Tipps und Tricks von Leon und Atze. Sie zeigen euch, wie ihr eure Sorgen gut betreut! Fühlt euch gut betreut Leon & Atze Instagram: https://www.instagram.com/leonwindscheid/ https://www.instagram.com/atzeschroeder_offiziell/ Mehr zu unseren Werbepartnern findet ihr hier: https://linktr.ee/betreutesfuehlen Tickets: Atze: https://www.atzeschroeder.de/#termine Leon: https://leonwindscheid.de/tour/ Quellen: Grundlagen zur generalisierten Angststörungen (und allen anderen psychischen Störungen) finden sich im Manual für psychische Störungen, dem DSM-5: Falkai, P., Wittchen, H. U., Döpfner, M., & American Psychiatric Association. (2015). Diagnostisches und statistisches Manual psychischer Störungen DSM-5®. Hogrefe. Informationen zur generalisierten Angststörung findet ihr in diesem Buch: Becker, E., & Margraf, J. (2017). Vor lauter Sorgen...: Selbsthilfe bei Generalisierter Angststörung. Beltz. In folgender Studie geht es um die Theorie der Emotionsvermeidung durch Sorgenketten: Laguna, L. B., Ham, L. S., Hope, D. A., & Bell, C. (2004). Chronic worry as avoidance of arousal. Cognitive Therapy and Research, 28, 269-281. Ein Buch dazu, wieso wir Angst und Sorge brauchen, findet ihr hier: Dennis-Tiwary, T. (2022). Future Tense: Why Anxiety is Good for You (even Though it Feels Bad). Hachette UK. Und hier ist ein spannender (englischsprachiger) Podcast mit der Autorin: Vedantam, S. (Moderator). (2022).A better way to worry – Hidden Brain Podcast: https://hiddenbrain.org/podcast/a-better-way-to-worry/ Tiefer einsteigen in das Problemlösetraining von D'Zurilla und Goldfried könnt ihr in diesem Paper: D'Zurilla, T. J., & Goldfried, M. R. (1971). Problem solving and behavior modification. Journal of abnormal psychology, 78(1), 107. Und zu guter Letzt befinden sich hier ein paar Zusammenfassungsstudien zur emotionalen Akzeptanz und den Effekten von Sport und Sorgen: Orcutt, H. K., Pickett, S. M., & Pope, E. B. (2005). Experiential avoidance and forgiveness as mediators in the relation between traumatic interpersonal events and posttraumatic stress disorder symptoms. Journal of Social and Clinical Psychology, 24(7), 1003-1029. Carter, T., Pascoe, M., Bastounis, A., Morres, I. D., Callaghan, P., & Parker, A. G. (2021). The effect of physical activity on anxiety in children and young people: A systematic review and meta-analysis. Journal of Affective Disorders, 285, 10-21. Kazeminia, M., Salari, N., Vaisi-Raygani, A., Jalali, R., Abdi, A., Mohammadi, M., ... & Shohaimi, S. (2020). The effect of exercise on anxiety in the elderly worldwide: a systematic review and meta-analysis. Health and quality of life outcomes, 18(1), 1-8

Katherine Koh, M.D., M.Sc., joins Dr. Dixon and Dr. Berezin, along with guest host Dr. Matt Hirschtritt, to discuss street psychiatry: what it is, its history, and what it means for the treatment of unhoused patients in often adverse settings. Transcript 01:08     What is street psychiatry? 05:03     Path into street psychiatry 08:24     Purpose of the article 09:22     What makes street psychiatry unique 14:09     "A long walk" 15:45     When does a person become a patient? 18:36     Rewards and challenges 26:14     Recovery and relationships 30:37     A philosophy of working with highly complex cases 35:14     Uncertainty and instability Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org  

Why Isn't TEAM More Popular? Why Do So Many Therapists Resist TEAM CBT? Featuring Matt May, MD Why has the therapeutic community been so resistant to TEAM? This topic has been a concern to me or many years. To be honest, it isn't new. From the very start of cognitive therapy, when I was first learning it, I began modifying it to make it more dynamic, powerful, and effective. But to be honest, I ran into a small (at the time) of Beck loyalists who branded me as an "outsider," something Beck also did when my book, Feeling Good, began to sell and gain popularity. This saddened and frustrated me, and still does, but it had some great spin-off. On my own, my ideas and approaches grew rapidly, and there was no scarcity of young therapists who wanted to work with me.  Below, you will ready Matt's take on why TEAM CBT has not caught on better, followed by my own thoughts. So read, and enjoy, and feel free to share your own thinking on this topic!  On the live podcast, you will hear our lively discussion with our beloved and brilliant host, Rhonda! Thanks for listening today!  Matt, Rhonda, and David Matt's take: Hi David, I'm excited to discuss this topic!  Also, I agree we would be hard-pressed to cover it in an hour, which I believe is the goal for the podcast. So, why isn't TEAM isn't more popular?  My short answer is that TEAM isn't more popular because many therapists don't want to learn it. Those reasons will vary from one person to another and relate to concepts in the model, itself, like 'process resistance' and 'outcome resistance'. While biological factors, like deficits in cognitive flexibility and neuroplasticity, the 'primacy effect' and age-related changes in the brain, combined with the complexity of the TEAM model, will make it near-impossible for some folks to learn it, these barriers are hard to address with our current technology For the purpose of this conversation, it probably makes more sense to consider the psychological barriers therapists have to adopting a model that is scientifically proven to be superior to other approaches.  As a proponent of TEAM and an instructor, I'd love to know what I'm doing wrong, in presenting the model and how to get more people excited about learning it.  While more research would help us see the problem more clearly, here are some factors that likely play a role: It seems humans have a hard time adopting new truths, regardless of the field being considered. I believe it was Schopenhauer who said all new truths go through three phases on the way to acceptance:  People will ridicule it, violently oppose it, then say they knew it all along as self-evident! One cause of this is something called the 'primacy effect'. People preferentially retain the first version of a story they hear.  If that information is corrected, later, they will continue to believe the first version they heard.  Biological Factors play a role in learning, including genetics, aging, illness and toxic exposure. 'Switching gears', mentally, is more challenging in people with Schizophrenia and their first-degree relatives, for example.  We know that neuroplasticity is greatest in our youth and declines over our lifespan.  Hence the importance of early education and attending to our overall health, habits, nutrition and medical care.       Socioeconomic and Cultural factors certainly play a role.  This is well documented in the book, 'The Emperor's New Drugs', showing how marketing prevailed over science in promoting "antidepressants".  Many therapists in training tell me, 'oh, they wouldn't let me use a measurement tool where I work'.   Lack of 'Critical Thinking'. What people believe often has nothing to do with what is evidence-based or logical.  Many people reject global warming despite the evidence and prefer to believe in conspiracy theories.  We tend to preferentially believe what someone says if we feel a kinship or loyalty to that person or view them as an 'expert'. People might believe RFK Jr. when he says immunizations are dangerous, for example, because he is in their political party and in a position of power, rather than review the science for themselves. Sunk-Cost Fallacy:  People who have gone through training may have a sense that they have invested too much time and money in their education to discard that model and start afresh. Even if we covered this in just a few minutes, we'd still be up against the hardest part of TEAM to learn, Agenda Setting.   Lots of 'Good Reasons' NOT to have open hands, explore topics paradoxically, and reasons this is challenging, technically. So, yeah, we'll have a lot to discuss and I'm looking forward to that! Sincerely, Matt Here is David's list Taking a page out of your book, Matt, our field is filled with so-called "schools" of therapy that function much like cults, most with a narcissistic "leader" at the helm. In a cult, members are required to be absolutely loyal, and to believe in claims the guru makes that have little or no evidence to back them up. For example, most "schools" of therapy claim to know "the" cause of emotional distress, when the causes of depression and other forms of emotional disturbance are still not known. What I have been suggesting is that we get rid of all the schools of therapy and usher in a new era of science-based, data-driven therapy, which would amount to a revolution in our field. This idea, which I feel passionate about, always meets with stiff and hostel opposition / push back. People just don't want to hear it. TEAM integrates high-level empathy and compassion with firm accountability. Give Stanford story with Sunny Choi, and the statement that "Stanford graduate students and faculty cannot be held accountable for doing psychotherapy homework. The need insight-oriented therapy!" This angrily issued statement conveyed, actually, two cult-like (to my thinking) components: First, we KNOW that patients should not be asked to do psychotherapy homework between sessions. Second, we KNOW that "insight-oriented therapy" is the treatment, without ever evaluating them. TEAM focuses on the here and now, and emphasize a "fractal" approach to treatment, where the same distortions and self-defeating beliefs will be embedded in the patient's negative thoughts and feelings every time she or he is upset. So, when you change the present, you have already changed the past. Whereas most therapies have traditionally (and still) focus on the past, thinking they will find the cause of the patient's distress in some pattern or traumatic event. TEAM focuses on rapid change in the here and now, where as many (most?) therapies focus on talk therapy that unfolds slowly, over a period of months, years, or even more. This DOES provide a powerful financial incentive to do "talk therapy," since this drastically provides financial security and reduces the incredible pressure of constantly have to find new patients. TEAM is very challenging to learn. I have taught over 50,000 therapists in the past 35 years or more, through my supervision of graduate students and psychiatric residents, my weekly training group at Stanford, and my workshops, including intensive, around the US and Canada. And one lesson that has emerged is just how difficult it is to learn TEAM. It requires a high level of intelligence and aptitude, and an unusual dedication and commitment. A great many of the most important tools, like Assessment of Resistance, and Externalization of Voices with the CAT, Self-Defense, and the Acceptance Paradox, are extremely difficult to learn and master.  And most give up, and drop out, in favor of some simpler and more formulaic therapy that is easy to learn. TEAM training requires constant role-playing with specific and immediate feedback on your performance, which includes bot a letter grade (A, B, C, etc.) as well as what you did that was effective, and where you fell short and might need to fine-tune your technique with frequent role reversals, always with feedback. This means lots of criticism along the way, which many (most?) therapists do not like. And although we repeatedly emphasize the philosophy of "joyous failure," and "learning through failure," most people do not buy it emotionally. We all want success and compliments! And NOT the "great death" of the self." The "great death" permeates every phase of the T E A M process. At the T = Testing, you will nearly always learn that your perceptions of your patients feel, and how they feel about you, are way off base. This is critically important, but painful for most, as it is a direct body blow to our "need" to be in the role of "expert." Unlike most other forms of therapy, we require therapists to measure patients' feelings, "in the here and now," at the start and end of every therapy session, using brief, highly reliable scales that assess feelings of depression, suicidal urges, anxiety, anger, and also happiness, as well as relationship satisfaction or discord. These scales function like an "emotional X-ray machine," allowing therapists for the first time to see exactly how effective or ineffective you were in every therapy session. Can you take it? On the positive side, this information will allow you to fine tune the therapy and learn from all of your patients every day. On the negative side, you may not want to have to "see" your failures before your eyes at every session with every patient. David: Tell the story of Tuesday group patient who proudly showed me her depression (and other scores) over the previous year with one of her patients. . . But there was absolutely no improvement in any scale. This was shocking and it made me very sad. My goal is to get dramatic changes within a single session. This "great death" continues during the E phase. TEAM therapists are required to ask "What's my grade on empathy" during the session, and also patients fill out the Empathy Scale and other scales on the "Patient's Evaluation of Therapy Session" right after the session. These scales are set up to make therapist failure common, almost universal at first. A warm and curious dialogue about where the therapist went wrong can revolutionize the therapy and deepen the relationship—quickly. But at what cost to the fragile ego of the insecure shrink? The "great death" continues with A = Paradoxical Agenda Setting. You give up your role as the "expert:" or "helper" or "rescuer," which many therapist refuse to do, and instead "become" the patient's subconscious resistance, arguing, with compassion and logic, that there are many GOOD reasons NOT to change. This freaks therapists out! The "great death" continues with the M = Methods phase of the session. I have developed roughly 140 methods to help people challenge distorted negative thoughts and self-defeating beliefs, and have always taught that no one method will work for everyone who's depressed and anxious. So you will have to try many methods, using the Recovery Circle, to find the one that works for each patient. But these methods are challenging to learn, and most therapists don't seem to have the intelligence, aptitude, or commitment to learning how to use them. Many of the methods and insights of TEAM or subtle nuances that many therapists do not "get" or perhaps do not want to "get." Example, the ACT training group, where someone held up the Feeling Good book and said, "We do not want THIS!" They falsely believed that "leaning into" your feelings is always the answer, and wrong believed that TEAM tried to make people happy all the time—called Toxic Positivity—whereas nothing could be further from the truth. In fact, I mentioned healthy negative feelings as early as, I think, Chapter 3 in Feeling Good, "Sadness is Not Depression," where I told the story of an elderly man who died on the Stanford inpatient medical service one evening when I was a medical student. Much of what I teach is shocking and at odds with what people are taught in graduate school. For example, the idea that most people with depression and anxiety—NOT everybody!—can be effectively treated in a single, extended therapy session. Curses! That sounds horrible! And even worse-sounding is the idea that change typically happens suddenly, at the very moment patients stop believing their distorted thoughts. Of course, since most therapists have not seen these phenomena, due perhaps to not having the skill, they insist instead that David is some type of fool, liar, or con artis. Okee Dokee! People—therapists and patients alike—do not "get" a great many of the key ideas in TEAM. For example, let's say the socially anxious patient totally believes the thought, "I shouldn't be so screwed up!" the necessary and sufficient conditions for emotional change. The necessary condition: The Positive Thought (PT) must be 100% true. Rationalizations and half-truths have never helped anybody. The sufficient condition: The PT must drastically reduce your belief in the negative thought. And that's when your negative thoughts will suddenly change. There is even more of what I teach is shocking and at odds with what people believe. For example, 2,000 years ago Epictetus stated they key premise of all the cognitive therapies: "People are disturbed, not by things, or events, but by the views they have of them". And recently, our research team has provided proof of this for the first time, in a study of nearly 7,000 users of our Feeling Great app, using sophisticated statistical modeling techniques. So, the three tenants of cognitive therapies, including TEAM, are: First, you FEEL the way you THINK. In other words, all of your positive and negative feelings result from your thoughts in the here-and-now. Second, depression and anxiety are the world's oldest cons. In other words, your negative thoughts, like "I'm not as good as I should be," or "I'm a hopeless case,"—will be loaded with many of the ten cognitive distortions and are extremely misleading—but you don't realize this when you're upset. You will believe these thoughts with all your heart and feel CERTAIN that they are 100% true. Third, you can CHANGE the way you FEEL. But lots of people will won't have it. They keep insisting on theories that simply aren't true—that emotions cause thoughts, for example—and on methods that may have little or no "punch" above and beyond the placebo effect. Story of Tuesday group student who was scolded in her graduate school counseling program for using the words "thought" or cognition during a therapy session. She was told ONLY to focus on feelings. Many people—therapists and patients alike—strongly believe that therapist empathy is THE key to healing. I have developed many powerful empathy tracking and training methods, but our clinical experience and research has shown, over and over, that therapist empathy is NOT the key to healing. They keys involve using TEAM systematically, and the rapid healing happens during the A and M for the most part. But those are the hard parts! Other problems include the idea that we can convert normal human emotional distress into a series of "mental disorders" that are listed in the DSM, the "bible" of the American Psychiatric Association. In TEAM, we consider each patient's patterns of suffering at the start of therapy, quickly and easily screened by the EASY Diagnostic System, but monitor therapy and patient progress with simple tools that measure feelings, like depression, anxiety, anger, and more. But this is an argument for another day. There's a lot more issues, too. Have I, David, contributed to the resistance to TEAM? Absolutely I have. I plead guilty as accused, and I'm proud of it. I'm totally aware that people—maybe even you— get turned off by criticism, and naturally recoil to protect your "in group," as Matt so clearly pointed out, and maintain loyalty to your "leader," whether it's Freud, Jung, Beck, Hayes, Rogers, or whoever. People are more emotional than rational, and people can be intentionally cruel and deceptive, too, all in the name of what they believe. We see that in our politics these days too. People believe things that are totally false, and wildly implausible, because the group or leader says it's true, it's the way things are. I'm a strong believer that science and truth will win out in the long run. Is this inevitable? I'm not totally confident, and have my doubts, but I am also filled with hope, and look to a future with more therapists like our beloved Matt May, MD and others who have dared to venture in a radically new direction, much like the early astronomers like Galileo and Copernicus who dared to challenge the superstitious teachings of the Catholic church. Those brave and brilliant early souls said, "things are NOT the way you think!" And they used data and mathematical modeling to prove their points. But there were a hundreds years of intimidation and suffering until people finally began to catch on to the then-ridiculous and outrageous ideas that the sun does NOT actually revolve around the earth, and that the earth is NOT the center of the universe. Those NOTS changed history. Can it happen again in the fields of psychiatry and psychotherapy? I hope so, and I've been giving my all, in my teaching, research, clinical work and writing, to make this happen. Sadly, I've fallen far short of my dream, but I'm thankful every day for what I've got, and the wonderful colleagues I'm privileged to know and love. Warmly, David, Matt and Rhonda

Scientific and Medical Consensus: Homosexuality is recognized as a normal variant of human sexual orientation. Major organizations, including the American Psychiatric Association (APA), the American Psychological Association, and the World Health Organization (WHO), affirm that same-sex attraction does not indicate a developmental or mental disorder.Removal from Diagnostic Manuals: In 1973, the American Psychiatric Association removed homosexuality from its Diagnostic and Statistical Manual of Mental Disorders (DSM), concluding that it did not meet the criteria for a psychiatric disorder. The World Health Organization followed suit, removing it from the International Classification of Diseases (ICD) in 1990.

Mental health is no longer a topic to be avoided at work. It's a critical factor impacting employee well-being, productivity and overall business success. Speakers from Hartford Hospital's Institute of Living, the American Psychiatric Association and Travelers explored mental health as a continuum and its connection to workplace safety. The panel provided actionable mental health strategies for leaders and managers to help them support worker well-being, strengthen organizational resilience and better understand emerging trends in workers compensation programs.This program is presented as part of the Travelers Institute's Forces at WorkSM initiative, an educational platform to help today's leaders navigate the shifting dynamics of the modern workplace and prioritize employees and their well-being.Watch the original Wednesdays with Woodward® webinar: https://institute.travelers.com/webinar-series/symposia-series/mental-health-at-work.   ---Visit the Travelers Institute® website: http://travelersinstitute.org/.Join the Travelers Institute® email list: https://travl.rs/488XJZM.Subscribe to the Travelers Institute® podcast newsletter on LinkedIn: https://www.linkedin.com/build-relation/newsletter-follow?entityUrn=7328774828839100417.Connect with Travelers Institute® President Joan Woodward on LinkedIn: https://www.linkedin.com/in/joan-kois-woodward/.

This week, Marianna sits down with Dr. Francine Cournos to talk about the importance of integrating mental health into HIV care. Tune in to hear about the differences between distress and disorders, screening and diagnosis, treatment, and more. -- Resources: National HIV Curriculum: https://www.hiv.uw.edu/The Circle of Health: https://www.va.gov/WHOLEHEALTH/circle-of-health/index.aspDiagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), American Psychiatric Association https://doi.org/10.1176/appi.books.9780890425787--Help us track the number of listeners our episode gets by filling out this brief form!  (https://www.e2NECA.org/?r=AQX7941)--Want to chat? Email us at podcast@necaaetc.org with comments or ideas for new episodes. --Check out our free online courses: www.necaaetc.org/rise-courses--Download our HIV mobile apps:Google Play Store: https://play.google.com/store/apps/developer?id=John+Faragon&hl=en_US&gl=USApple App Store: https://apps.apple.com/us/developer/virologyed-consultants-llc/id1216837691

Yang Lu, M.S., and Catharine E. Fairbairn, Ph.D. (University of Illinois, Urbana-Champaign) join AJP Audio to discuss the longitudinal effects of the use of personal alcohol breathalyzers in a natural setting on alcohol usage. Afterwards, AJP Editor-in-Chief Dr. Ned Kalin joins the podcast to discuss the rest of the April issue, which focuses on subjects related to substance use disorders. 00:57     What did you discover about the long term effects of using a personal blood alcohol monitor? 03:12     Do health monitoring devices actually change behaviors? 04:10     What did your cohort look like? 08:49     Disparate impact of monitoring on heavy drinkers and light drinkers 11:36     Clinical implications 14:34     Limitations 15:46     Avenues for further research 18:39     Kalin interview 18:46     Lu et al. 24:00     Wittekind et al. 29:50     Nicholson et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

I attended a recent conference hosted by Northern California Psychiatric Society and the American Psychiatric Association that focused on many relevant and up to date topics, and in this episode I'll share some key pearls on themes related to climate anxiety, sleep, AI chatbots, neurodiversity, and more. To learn more about me and my reproductive & integrative psychiatry clinic helping patients across California, please visit - AnnaGlezerMD.comTo sign up for the Fellowship in Reproductive & Integrative Psychiatry, please visit:  PsychiatryFellowship.com. 

Are we limiting our mental health toolkit? In a world focused on “symptoms and medications,” Dr. Emma Bragdon introduces a structured, community-based path to wellness: Spiritism. Founded by Allan Kardec and widely practiced in Brazil, Spiritism blends spirituality with ethical practice and study. In this conversation, we explore how it reframes certain mental health experiences, provides ethical guardrails for mediums, and reflects a growing interest in spirituality within mental health—recognized even by the American Psychiatric Association. If traditional care feels incomplete, this episode explores how integrating spirituality may support deeper healing and human potential.undefined

Chelsea Dyan Gober Dykan, M.A. (Tel Aviv University, Israel), joins AJP Audio to discuss a study looking at two versions of attention bias modification with an eye towards a prophylactic impact on developing PTSD in a cohort of combat-bound soldiers.  Afterwards, AJP Editor-in-Chief Dr. Ned Kalin joins the podcast to put the rest of the March issue into context. 00:57   Attention bias modifications 03:54   Response-time and gaze-contingent paradigms 05:05   Differences in efficacy between the two arms 08:06   Ethical considerations in investigating combat-bound soldiers 10:44   Controlling for combat experiences in studying PTSD 12:24   Duration of the effect 13:44   Limitations 15:03   Immediate clinical implications 16:22   Further research 17:05   Kalin interview 17:22   Dykan et al. 21:03   Kaul et al. 26:19   Kantrowitz et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Despite major advances in our understanding of the biology of mental health disorders,  there's no blood test or brain scan that will confirm if you have depression, anxiety, PTSD, or any other psychiatric illness.  And yet, the American Psychiatric Association recently announced that it will be including biomarkers for mental conditions in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which guides diagnosis and treatment of mental illness. So how close are we to pinpointing the biological markers of mental illness, and what does that mean for diagnosis? It's complicated.  Host Flora Lichtman untangles some of this science with psychiatry researcher John Krystal. Guest: Dr. John Krystal is a professor of psychiatry, neuroscience, and psychology at the Yale School of Medicine. Transcripts for each episode are available within 1-3 days at sciencefriday.com. Subscribe to this podcast. Plus, to stay updated on all things science, sign up for Science Friday's newsletters.

In this episode of I Thought You'd Like to Know, Marcus Peter of Ave Maria Radio Interviews Stephen Rouhana on his book The King and Queen are Naked: Establishment Failures based on Scientific, Medical, and Psychiatric Research on “Gender Dysphoria” (February 9, 2026)This book is the result of analysis of the literature on Gender Dysphoria published in journals of psychology, psychiatry, and medicine, and in other relevant publications.In part one, Dr. Rouhana starts from basic definitions and leads the reader through the maze of articles and opinions on the subject to the unavoidable conclusion that the gender identity issues underlying Gender Dysphoria do constitute a mental disorder. He examines how the current recommendations in the Diagnostic and Statistics Manual of Mental Disorders (DSM) published by the American Psychiatric Association have been intentionally written to mislead the general public and medical insurance companies.In part two, Dr. Rouhana explores what ethical treatments are, and are not, for Gender Dysphoria given the conclusions from part one.In part three, he explores what the Catholic Church has taught on this topic, from the perspective of faith and philosophy. Each part ends with proposed actions to truly help those suffering with this issue.The King and Queen are Naked: Establishment Failures based on Scientific, Medical, and Psychiatric Research on “Gender Dysphoria” by Stephen W. Rouhana, Ph.D. | En Route Books and Media

By David Stephen who looks at biomarkers in this article. Will there ever be a biological test for human intelligence, to explore how to improve it in the age of AI? Like, would it ever be possible to test a human being for intelligence by some biological factor, and how to make it competitive against AI? The same question applies to mental disorders. Would there ever be biological tests, to know what therapies would work? These, at least for mental disorders, is what the American Psychiatric Association is seeking. Biomarkers for Psychiatry, Human Intelligence There is a recent [January 28, 2026] press release, APA Releases Roadmap for the Future of the DSM, stating that, "The American Psychiatric Association (APA) has released a series of papers offering a proposed roadmap for the future of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The five papers, including the Initial Strategy for the Future of the DSM and four accompanying commentaries, are the result of the committee's year of structured debate and consideration of long-standing critiques and rapid scientific advances. They propose a forward-looking model for the evolution of the DSM. They also suggest changing the name from Diagnostic and Statistical Manual to Diagnostic and Scientific Manual to better reflect its scientific and global scope. The four accompanying papers address structure and dimensions of the DSM; the role of biomarkers and biological factors in diagnosis; vision for incorporating socioeconomic, cultural and environmental determinants of health and intersectionality; and the role of functioning and quality of life in psychiatric diagnosis." Conceptual Biomarkers and Theoretical Biological Factors for Psychiatric and Intelligence Nosology What are the options for biomarkers in the brain for mental disorders? Would they be different or similar to those for human intelligence? What are the universal components in the brain, for functions of human life and experiences? Can a model be developed on these components and their mechanisms, first to explain labels and next to scope out biomarkers? The problem before psychiatry is not just the distance to developing tests but to even describe what is happening in the brain for the labels of conditions. Mood disorders have several descriptions. But what are their components in the brain and the course of their actions. Answering these questions can put conditions in perspective as parallels are sought, before adventuring into biomarkers development. The same applies to human intelligence. Now, artificial intelligence is in an intense acceleration. There are valuable labor tasks that will be lost due to AI. And, because intelligence is the last frontier of superiority for humanity among organisms, it will be important to seek to map it, and explore it for problem-solving. This is the postulation in Conceptual Biomarkers and Theoretical Biological Factors for Psychiatric and Intelligence Nosology. The options are electrical and chemical signals as the components of functions in the brain. It states that neurons are conduits or bridges that signals use to carry out functions. It also states that signals are in sets in cluster of neurons. It is possible to use signals, conceptually, to explain and display all disorders in the DSM. It is also possible to use them to develop, explain, and display the two main types of human intelligence [improvement and operational], to ensure that options are broadened towards survival in the age of AI. This seminal work on conceptual brain science could be completed by August, 2026, moving psychiatry and intelligence forward, as well as neurology. David Stephen currently does research in conceptual brain science with focus on the electrical and chemical configurators for how they mechanize the human mind with implications for mental health, disorders, neurotechnology, consciousness, learning, artificial intelligence and nurture. He was a visiting scholar in m...

Send a Text to the Moms - please include your contact info if you want a response. thanks!Guest: Dr. Theresa Miskimen Rivera, APA president 2025-2026In this episode, we're joined by the current president of the American Psychiatric Association for a timely conversation on what's broken—and what's possible—in mental healthcare. We explore the promise of integrated behavioral healthcare, why treating the whole person matters, and how earlier diagnosis can change lives. Just as important, we shine a light on the often-overlooked plight of caregivers supporting loved ones with schizophrenia and other serious mental illnesses—those doing the hardest work with the least support.Link:https://www.psychiatry.org/Thanks for liking and sharing the podcast! Mindy and her book: https://mindygreiling.com/Randye and her book: https://randyekaye.com/Miriam and her book: https://www.miriam-feldman.com/Want to know more?Join our facebook page Our websites:Randye KayeMindy Greiling Miriam (Mimi) Feldman

Dr. Ian Kelleher (University of Edinburgh, Scotland) joins AJP Audio to discuss an emulated target trial looking at the prophylactic qualities of doxycycline, an antibiotic, in an adolescent population at risk to develop schizophrenia spectrum disorder.  Afterwards, AJP Editor-in-Chief Dr. Ned Kalin joins the podcast to put the rest of the issue into context. 00:53   Doxycycline and the risk of developing schizophrenia 04:03   Emulated target trials versus randomized control trials 06:43   Methods of action 09:24   Dosage and exposure levels for doxycycline 10:15   Immediate clinical applications 10:56   Limitations of the study 11:33   Future research 12:43   Kalin interview 13:00   Lång et al. 19:43   Zhao et al. 25:20   Metrik et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

This special episode of AJP Audio brings together the editors of the American Journal Psychiatry and the AJP Residents' Journal to discuss important and impactful articles published in 2025. 00:39   Ned H. Kalin, M.D., discusses "Transcriptomic Analysis of the Human Habenula in Schizophrenia" by Ege A. Yalcinbas, Ph.D., et al. 06:23   Elisabeth Binder, M.D., Ph.D., discusses "Copy Number Variant Architecture of Child Psychopathology and Cognitive Development in the ABCD Study" by Zhiqiang Sha, Ph.D., et al. 11:17   Kathleen T. Brady, M.D., Ph.D., discusses "High-Potency Cannabis Use and Health: A Systematic Review of Observational and Experimental Studies" by Stephanie Lake, Ph.D., et al. 15:35   David A. Lewis, M.D., discusses "20 Years of Aberrant Salience in Psychosis: What Have We Learned?" by Philip R. Corlett, Ph.D., and Kurt M. Fraser, Ph.D. 17:27   William M. McDonald, M.D., discusses "Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research" by Roger S. McIntyre, M.D., F.R.C.P.C., et al. 24:04   Daniel S. Pine, M.D., discusses "Cognitive Behavioral Therapy and Lisdexamfetamine, Alone and Combined, for Binge-Eating Disorder With Obesity: A Randomized Controlled Trial" by Carlos M. Grilo, Ph.D., et al. 26:06   Carolyn Rodriguez, M.D., Ph.D., discusses "Randomized Controlled Trial of the Effects of High-Dose Ondansetron on Clinical Symptoms and Brain Connectivity in Obsessive-Compulsive and Tic Disorders" by Emily R. Stern, Ph.D., et al. 30:26   Sean T. Lynch, M.D., discusses "From Medical Practice to Mass Incarceration: A Historical Analysis of Racial and Ethnic Targeting in U.S. Drug Policy" by Rathisha Pathmathasan, D.O., et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org  

For decades, the narrative surrounding schizophrenia has focused almost exclusively on controlling symptoms. But with no cure, can someone actually get better? Recovery in the context of schizophrenia isn't about the absence of symptoms. It's a deeply personal process — one that centers on restoring hope, self-determination, and a meaningful life, even when hallucinations, delusions, and setbacks continue to exist. In this episode, host Rachel Star Withers, who lives openly with schizophrenia, and co-host Gabe Howard explore what recovery really means for people with serious mental illness. From clinical symptom remission and functional abilities to redefining purpose and identity, they unpack how recovery can look — and why it rarely fits the “back to normal” expectation held by loved ones and society. Later in the episode, Dr. Mark Ragins, who is a pioneer and leading voice in person-centered, recovery-based psychiatry, joins the conversation. Listener takeaways  why people — not illness — should be at the center of treatment how recovery can include setbacks and still be real progress how the psychosis triangle explains both breakdown and healing how relationships can stabilize psychosis even when symptoms persist Listen now as this episode challenges outdated ideas of recovery, validating lived experience and showing how a meaningful life is possible with schizophrenia, symptoms and all. Our guest, Mark Ragins, MD, has been a psychiatrist for 40 years, working in community mental health centers, as the Medical Director for 27 years at the Mental Health America Village in Long Beach, California, an award-winning model of recovery-based mental health services, as the students' psychiatrist at Cal State Long Beach, and on street medicine teams working with homeless people on the streets throughout LA county. His book, “Journeys Beyond the Frontier: A Rebellious Guide to Psychosis and Other Extraordinary Experiences,” is based on true stories of working with some of the most underserved and difficult-to-engage people in our community. Countless people have come to experience the work being done at the Village firsthand and Mark has given hundreds of presentations and lectures to wide-ranging audiences nationally and internationally. He is one of the true pioneers and leaders of person-centered, recovery-based psychiatry. Many of his writings are posted online at markragins.com, including his short book A Road to Recovery. He was also featured in Steve Lopez's book The Soloist. Over the years, Mark has won a number of awards, including from the American Psychiatric Association, the Psychiatric Rehabilitation Association, NAMI, and Mental Health Advocacy Services. Our host, Rachel Star Withers, (Link: www.rachelstarlive.com) is an entertainer, international speaker, video producer, and schizophrenic. She has appeared on MTV's Ridiculousness, TruTV, NBC's America's Got Talent, Marvel's Black Panther, TUBI's #shockfight, Goliath: Playing with Reality, and is the host of the HealthLine podcast “Inside Schizophrenia”. She grew up seeing monsters, hearing people in the walls, and having intense urges to hurt herself. Rachel creates videos documenting her schizophrenia, ways to manage, and letting others like her know they are not alone and can still live an amazing life. She has created a kid's mental health comic line, The Adventures of ____. (Learn more at this link: https://www.amazon.com/Adventures-Fearless-Unstoppable-Light-Ambitious/dp/B0FHWK4ZHS ) Fun Fact: She has wrestled alligators. Our cohost, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. To learn more about Gabe, please visit his website, gabehoward.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

Can Therapists Start a Union? The Antitrust Trap, the Shadow Committee, and the Economic Strangulation of American Psychotherapy Analyzing America's Healthcare Regulations and Their Effect on Us: Why the Law Prevents Therapists from Organizing While Allowing a Private Committee to Fix Prices for the Entire Medical System https://gettherapybirmingham.com/can-therapists-start-a-union-spoiler-alert-they-cant/ The Monthly Rage Thread If you hang around therapist forums long enough, you will see it happen. It operates with the regularity of the tides. Someone posts a thread, usually after receiving a contract from an insurance company offering 1998 rates for 2025 work, and asks the obvious question: “We are the ones providing the care. The system collapses without us. Why don't we just all go on strike? Why don't we form a union and demand fair pay?” It is a logical question. In almost every other sector of the economy, workers who feel exploited band together to negotiate better terms. Screenwriters shut down Hollywood to get paid for streaming residuals. Auto workers walk off the line. Teachers fill the state capitol. Nurses at major hospital systems have successfully unionized and won significant concessions. So why, in the midst of a national mental health crisis, does the mental health workforce remain so politically impotent? The answer is not that we lack will. It is not that we lack organization. The answer is that for private practice therapists, forming a union is a federal crime. This is not a political manifesto. It is an analysis of the bizarre regulatory environment that governs American healthcare, a system of antitrust laws, shadow committees, and bureaucratic classifications that effectively strips clinicians of their bargaining power while empowering the corporations that pay them. If you want to understand why corporate tech monopolies are ruining therapy, or why the corporatization of healthcare feels so suffocating, you have to understand the legal straitjacket we are all wearing. And you have to understand the one group that is allowed to set prices, the one group exempt from the rules that bind the rest of us. Part I: You Are Not a Worker, You Are a Standard Oil Tycoon The primary reason therapists cannot unionize dates back to the era of oil barons and railroad tycoons. The Sherman Antitrust Act of 1890 was designed to prevent massive corporations like Standard Oil from colluding to fix prices and destroy the free market. It prohibits “every contract, combination… or conspiracy, in restraint of trade.” The law was a response to genuine abuses: companies buying up competitors, dividing territories, and coordinating prices to gouge consumers who had no alternatives. Here is the catch: In the eyes of the federal government, a private practice therapist is not a “worker.” You are a business entity. Even if you are a solo practitioner struggling to pay rent in a subleased office, seeing clients between crying in your car and eating lunch at your desk, the law views you as the CEO of a micro-corporation. You are classified as a 1099 independent contractor, not a W-2 employee, and that distinction makes all the difference in the world. If two workers at Starbucks talk about their wages and agree to ask for a raise, that is “collective bargaining,” which is protected by the National Labor Relations Act. But if two private practice therapists talk about their reimbursement rates and agree to ask Blue Cross for a raise, that is “price-fixing.” It is legally indistinguishable, in the eyes of the Federal Trade Commission, from gas stations conspiring to raise the price of unleaded. It sounds absurd, but the FTC takes it deadly seriously. When independent contractors organize to demand higher rates, when they share information about what they are being paid and coordinate their responses, they are engaging in horizontal price-fixing, one of the most serious violations of antitrust law. The Sherman Act provides for criminal penalties, including fines and imprisonment. The law that was meant to break up monopolies is now used to prevent social workers from asking for a cost-of-living adjustment. The irony is crushing. The same regulatory framework that prevents two therapists from discussing their rates allows massive insurance conglomerates to merge repeatedly, concentrating buyer power in fewer and fewer hands. UnitedHealth Group, for example, has acquired dozens of companies over the past two decades, becoming the largest healthcare company in the United States. When they offer a “take it or leave it” contract to providers, they do so with the full knowledge that fragmented, legally prohibited from organizing therapists have no counter-leverage. The antitrust laws, designed to prevent monopoly power, have created a system where sellers are atomized and buyers are consolidated. Economists call this “monopsony,” and it is precisely the market distortion the Sherman Act was supposed to prevent. Part II: The Day the “Learned Profession” Died For a long time, doctors and lawyers thought they were exempt from these laws. They argued that they were “learned professions,” not mere tradespeople, and therefore above the grubby laws of commerce. They believed that their ethical obligations to patients and clients set them apart from the rules that governed steel mills and meatpacking plants. Medicine was a calling, not a business, and surely the government would not regulate the sacred doctor-patient relationship as if it were a commercial transaction. That illusion was shattered in 1975 by the Supreme Court case Goldfarb v. Virginia State Bar. The case involved lawyers, not doctors, but its implications cascaded through every licensed profession in America. The Goldfarbs were purchasing a home and needed a title examination. The Virginia State Bar had established a minimum fee schedule for such services, and every lawyer they contacted quoted the exact same price. They sued, arguing that this fee schedule was illegal price-fixing. The Supreme Court agreed. In a unanimous decision, the Court ruled that professional services, including legal and medical advice, are “trade or commerce” subject to antitrust laws. The “learned profession” exemption, which had been assumed but never explicitly established in law, was declared a myth. “The nature of an occupation, standing alone,” the Court wrote, “does not provide sanctuary from the Sherman Act.” This ruling was intended to lower prices for consumers by preventing lawyers from setting minimum fees, and in that narrow sense it was a good thing. But in healthcare, it had a catastrophic side effect: it made it illegal for doctors and therapists to band together to resist the pricing power of insurance companies. The “learned profession” exemption is dead. We are now just businesses, and businesses are not allowed to hold hands. This creates the illusion of progress: we have “free market” competition among providers, but monopsony power among payers. It is a market where the sellers are forbidden from organizing, but the buyers are allowed to merge until they are too big to fail. The result is not a free market at all. It is a market designed to transfer wealth from one class (providers) to another (insurers and administrators), with the law itself serving as the enforcement mechanism. Part III: The Cartel in the Basement If therapists cannot collude to set prices, surely nobody else can, right? Wrong. There is one group in American healthcare that is allowed to meet in a room, decide what every doctor's time is worth, and set prices for the entire industry. It is called the RUC, the AMA/Specialty Society Relative Value Scale Update Committee. And understanding the RUC is the key to understanding why talk therapy is dying in the medical model, why psychiatrists abandoned the couch for the prescription pad, and why your insurance company offers you a ghost network of providers who never answer the phone. The Birth of a Shadow Government To comprehend the current crisis in mental health economics, one must excavate the foundations of the physician payment system. Prior to 1992, Medicare reimbursed physicians based on a system known as “Customary, Prevailing, and Reasonable” charges. Under this system, physicians were paid based on their historical billing charges. It was inherently inflationary; it rewarded those who raised their fees most aggressively and created wide geographic disparities for identical services. In response to spiraling costs, Congress passed the Omnibus Budget Reconciliation Act of 1989, mandating a transition to a fee schedule based on the resources required to provide a service. This birthed the Resource-Based Relative Value Scale. The intellectual architecture for this system was developed by a team of economists at Harvard University, led by William Hsiao. Hsiao's team sought to create a “unified theory” of medical value, attempting to quantify the “work” involved in disparate medical acts, comparing the cognitive intensity of a psychiatric evaluation with the technical skill of a hernia repair. The Harvard study was revolutionary. It promised to level the playing field, suggesting that cognitive services, the thinking and talking that comprises primary care and mental health, were vastly undervalued relative to surgical procedures. Had Hsiao's original recommendations been implemented purely, the income gap between generalists and specialists might have narrowed significantly. But the administrative complexity of assigning values to over 7,000 Current Procedural Terminology codes overwhelmed the Health Care Financing Administration. Into this administrative vacuum stepped the American Medical Association. The AMA, fearing that the government would unilaterally set prices, proposed a “partnership.” They would convene a committee of experts to maintain and update the relative values, providing this labor-intensive service to the government at no cost. The government accepted. Thus, in 1991, the RUC was born, not as a government agency, but as a private advisory body with unparalleled influence over public funds. The Architecture of Control The RUC's claim to legitimacy rests on its status as an “expert panel.” But a structural analysis of its composition reveals a profound bias that mimics the governance of a cartel designed to protect incumbent interests. The committee consists of 32 members, but power is concentrated in the 29 voting seats. Of these, 21 seats are appointed by major national medical specialty societies. The distribution is not proportional to the volume of services provided to Medicare beneficiaries, nor is it proportional to the physician workforce. Instead, it is frozen in a historical moment that favored high-technology specialties. Primary care physicians, who perform roughly 45 to 50 percent of Medicare work, hold approximately 4 to 5 seats, giving them about 17 percent of the vote. Procedural and surgical specialties, including surgery, radiology, and anesthesiology, hold 15 to 18 seats, giving them roughly 60 percent of the vote despite performing only 35 to 40 percent of Medicare work. The American Psychiatric Association holds a single seat. One seat. This lone representative must negotiate with a supermajority of specialists, neurosurgeons, cardiothoracic surgeons, radiologists, and ophthalmologists, whose financial interests are often diametrically opposed to the valuation of cognitive work. The cartel dynamic is enforced by a statutory requirement of budget neutrality. The Medicare Physician Fee Schedule is a zero-sum game. If the total relative value units projected for a given year exceed the budget, a “scaler” is applied to reduce the conversion factor, effectively cutting everyone's pay. Therefore, any proposal to increase the value of psychotherapy, which would increase the total RVU spend, effectively asks every surgeon in the room to take a pay cut to fund the raise for psychiatrists. Given that a two-thirds majority is required to pass a recommendation, the procedural bloc holds absolute veto power over any redistribution of wealth. The Secret Chamber A hallmark of cartel behavior is the restriction of information. For nearly two decades, the RUC operated in near-total secrecy. While recent years have seen minor concessions to transparency, such as the publication of vote totals, the core deliberative process remains opaque. RUC meetings are private. The public, the press, and even non-RUC physicians are largely barred from attending the deliberations where billions of tax dollars are allocated. Participants, including the specialty advisors who present data, must sign strict non-disclosure agreements. These agreements prevent them from discussing the specific tradeoffs, deals, or arguments made within the chamber. A former RUC participant described these agreements as “draconian,” designed to insulate the committee from public accountability. The Government Accountability Office and the Center for American Progress have noted the inherent conflict of interest. The individuals setting the prices are the same individuals who receive the payments. Unlike a regulatory agency, where officials are salaried and divested of industry assets, RUC members are practicing physicians whose personal incomes are directly tied to the decisions they make. This secrecy serves a functional purpose: it allows for “logrolling.” A representative from Orthopedics might support an inflated value for a Cardiology code in exchange for Cardiology's support on a Knee Replacement code. This “I'll scratch your back” dynamic creates an upward pressure on procedural values that excludes those outside the dominant coalition, specifically primary care and mental health. The Antitrust Shield Why has the Department of Justice not broken up this cartel? The legal shield is the Noerr-Pennington Doctrine. This Supreme Court doctrine establishes that private entities are immune from antitrust liability when they are petitioning the government. Because the RUC technically only “recommends” values to CMS (that is petitioning), and CMS “decides” (that is government action), the RUC is protected by the First Amendment right to petition. This legal loophole allows the RUC to operate with monopolistic characteristics without fear of prosecution, provided CMS continues to go through the motions of “reviewing” the recommendations. And CMS accepts those recommendations over 90 percent of the time. Because private insurance companies generally base their rates on Medicare, this private committee effectively sets the price of healthcare for the entire country. If independent therapists did this, if they gathered in a room and agreed on what their services should cost, they would face criminal prosecution. But because the RUC operates under the fiction of “advising” the government, it is protected. The same regulatory framework that criminalizes therapist solidarity provides cover for industry-wide price coordination by the most powerful medical specialties. Part IV: The Mechanics of Suppression To control a market, one must control its currency. In American medicine, that currency is the Relative Value Unit. Every medical service, from a 15-minute therapy session to a heart transplant, is assigned a total RVU value. This value is the sum of three components: the Work RVU, which accounts for physician time, technical skill, mental effort, and judgment; the Practice Expense RVU, which covers overhead costs like rent, staff, and equipment; and the Malpractice RVU, which reflects professional liability insurance costs. The Work RVU, which comprises roughly 50 to 55 percent of the total value, is determined by RUC surveys. When a code is flagged for review, the relevant specialty society distributes a survey to a sample of its members. These respondents are asked to estimate the time and intensity of the service compared to a “reference service.” This methodology violates several principles of statistical validity. The surveys are voluntary and distributed by the specialty societies themselves. The respondents are typically those most active in the society and most invested in maximizing reimbursement, advocates rather than neutral observers. The sample sizes are often shockingly small; RUC surveys frequently rely on fewer than 50 or 70 respondents to set the price for services performed millions of times annually. A sample of 30 orthopedic surgeons might determine the value of a procedure costing Medicare billions. The Time Arbitrage The most critical variable in the RUC equation is time. The Work RVU is conceptually derived from the formula: Work equals Time multiplied by Intensity. Therefore, inflating the time estimate is the most direct route to inflating the price. Independent studies by RAND and the Urban Institute, often using objective data like Operating Room logs, have consistently shown that the RUC overestimates the time required for surgical procedures. A procedure valued by the RUC as taking 60 minutes may, in reality, take 30 minutes. This creates an arbitrage opportunity. If a gastroenterologist can perform a “60-minute” colonoscopy in 20 minutes, they can effectively perform three procedures in the time allotted for one. They bill for three hours of work in one hour of real time. This “efficiency gain” is captured entirely by the physician as profit. Psychotherapy cannot utilize this arbitrage. CPT codes for psychotherapy are explicitly time-based in their definition. Code 90832 requires 16 to 37 minutes. Code 90834 requires 38 to 52 minutes. Code 90837 requires 53 minutes or more. A psychiatrist cannot perform a 60-minute therapy session in 20 minutes; doing so constitutes fraud. Therefore, the revenue of a psychotherapist is capped by the linear passage of time. They can sell, at maximum, roughly 8 to 10 units of labor per day. A proceduralist, aided by RUC-inflated time assumptions, can sell 20 or 30 units of “RUC time” in the same day. This structural discrepancy creates a widening income gap that no amount of “hard work” by the therapist can close. It is not a market failure. It is market design. The “Thinking” Penalty The RUC's bias is not merely structural; it is philosophical. The committee, dominated by surgeons and proceduralists, consistently values “doing things to people,” cutting, scanning, injecting, far more highly than “talking to people,” diagnosing, counseling, managing complex chronic conditions. This creates a regulatory environment that functions as a de facto wealth transfer from cognitive care to procedural care. In 2013, a major revision of psychiatry codes exposed this bias in stark relief. Previously, psychiatrists used codes that bundled the medical evaluation with the psychotherapy. The new system required psychiatrists to bill an E/M code for the medical management plus an “add-on” code for psychotherapy. While intended to improve transparency, this change exposed psychotherapy to the raw mechanics of the RUC's valuation bias. By isolating the “therapy” component, the committee could subject it to rigorous cross-specialty comparison. And the committee, dominated by surgeons, views “talking to a patient” as low-intensity work compared to “operating on a patient.” The economic signal was clear. This created the 15-minute med check culture not because psychiatrists stopped caring, but because the regulatory environment made relational care financial suicide. It effectively “illegalized” the practice of deep, slow psychiatry for anyone who wanted to take insurance. Part V: The “Messenger Model” and Other Legal Fictions When therapists ask about collective bargaining, lawyers will often point them to the only legal loophole available: the “Messenger Model.” In this model, a third party (the messenger) acts as an intermediary between a group of providers and an insurance company. The messenger takes the insurance company's offer and conveys it to each therapist individually. Each therapist must then make a unilateral, independent decision to accept or reject it. The messenger is strictly forbidden from negotiating. They cannot say, “The group rejects this.” They cannot say, “We want 10% more.” They cannot advise the therapists on what to do. They can only carry messages. This is why “Independent Practice Associations” are often toothless. In the 2008 case North Texas Specialty Physicians v. FTC, the Fifth Circuit Court of Appeals made clear that if an IPA actually tries to leverage its numbers to demand better rates, it violates antitrust laws. If it follows the messenger model, it has no leverage. It is a “heads I win, tails you lose” regulatory structure designed to protect payers, not providers. The only exception is “clinical integration,” where providers genuinely merge their practices, share infrastructure, and accept joint financial risk. But this requires substantial capital investment and essentially means ceasing to be an independent practitioner. It is a legal pathway available mainly to large physician groups and hospital systems, not to solo therapists working out of rented offices. Part VI: Market Distortions and the Flight to Cash When a cartel sets a price below the market equilibrium, suppliers exit the formal market. This is precisely what has happened in psychotherapy. Mental health providers generally have lower overhead than surgeons. They do not need MRI machines or sterile surgical suites. And they face high consumer demand; the national mental health crisis ensures a steady stream of people seeking services. This gives them an “exit option” that proceduralists do not have. They can refuse to accept insurance and operate as cash-only businesses. The statistics are stark. Nearly 50 percent of psychiatrists do not accept commercial insurance, compared to less than 10 percent of other specialists. A 2023 survey indicated that 64 percent of private practice therapists planned to increase their cash-pay rates. Research published in Health Affairs Scholar found that patients are 10.6 times more likely to go out-of-network for mental health care than for medical/surgical care. This mass exodus is a rational economic response to RUC-suppressed rates. If the RUC says an hour of therapy is worth $100 via the RVU-to-dollar conversion, but the market demand is willing to pay $250, the provider will leave the RUC-controlled sector. They are not abandoning their profession; they are abandoning a pricing regime that values their work at less than half its market rate. Ghost Networks The RUC's pricing failure creates “Ghost Networks,” directories filled with providers who are ostensibly “in-network” but are functionally inaccessible. They are either full, not accepting new patients, retired, have moved, or simply do not respond to inquiries from insurance-based patients because the administrative burden of prior authorizations and clawbacks outweighs the suppressed fee. This is not a “shortage” of providers in the absolute sense. There is no shortage of therapists in private practice. There is a shortage of therapists willing to work at the RUC-determined price point. The insurance directories are graveyards of phantom availability, creating the illusion of access where none exists. The Cost Paradox The central thesis of the RUC's defenders is that they “control costs.” By strictly managing RVUs, they claim to save taxpayer money. In psychotherapy, this logic backfires catastrophically. By suppressing reimbursement rates to a level that drives providers out of the network, the RUC forces patients into the cash market. The theoretical in-network cost might be a $20 copay with the insurer paying $100. The actual out-of-network cost is $250 cash out-of-pocket, paid in full by the patient. Thus, the “cost of therapy” for the consumer skyrockets. Therapy becomes a luxury good, accessible only to those with disposable income. For the poor and middle class, the “cost” is effectively infinite, because the service becomes inaccessible. The RUC's cost-control measure for the system becomes a cost-multiplier for the patient. It shifts the financial burden from the risk pool, where it belongs, to the individual, where it causes maximum harm. The Signal to Students The RUC sends powerful economic signals to medical students making career decisions. When a student observes that a dermatologist or radiologist can earn $500,000 working regular hours, while a psychiatrist earns $240,000 handling emotional trauma and on-call emergencies, while a primary care doctor earns even less, the choice is clear for those motivated by financial security. The undervaluation of cognitive codes discourages the best and brightest from entering mental health and primary care. The cartel's pricing structure creates a perpetual labor shortage in the fields most needed for public health, while creating a surplus in high-margin procedural specialties. We then wonder why there are not enough psychiatrists, why primary care is in crisis, why mental health access is collapsing. The answer is in the price signal, and the price signal is set by a committee of proceduralists meeting behind closed doors. The Hands Are Tied The question “Why can't therapists start a union?” is not just a labor question. It is a window into the broken soul of American healthcare. We have built a system where a secret committee of proceduralists can legally fix prices to favor surgery over therapy, but a group of social workers cannot band together to ask for a living wage. We have utilized laws meant to break up Standard Oil to break up the solidarity of caregivers. The same regulatory framework that criminalizes therapist coordination provides legal cover for industry-wide price coordination by the most powerful medical specialties. The result is a regulatory environment that drives doctors crazy, burns out therapists, and leaves patients navigating a fragmented, assembly-line system that was never designed to heal them. It was designed to process them. Until we confront the legal architecture of this system, the RUC, the Sherman Act, the 1099 trap, we will remain powerless to change it. And the reality of therapy is that quick fixes, whether in treatment or in policy, usually end up costing us more in the end. Some states are beginning to push back. New York and California have implemented strict network adequacy standards requiring mental health appointments within 10 business days. These regulations force insurers to expand their networks, which means they must attract providers, which means they must raise reimbursement rates above the RUC/Medicare floor. It is effectively a state-level override of the RUC cartel, forcing capital back into the mental health labor market. The Medicare Payment Advisory Commission has long advocated for stripping the RUC of its power, proposing the use of empirical data, tax returns, payroll records, practice invoices, to set values automatically. But these are patchwork solutions to a systemic problem. The fundamental issue remains: we have created a healthcare system that knows the price of everything and the value of nothing. We have engineered a system where the only way to survive is to stop acting like a healer and start acting like a factory. And we have wrapped this system in a legal framework that criminalizes resistance while protecting the status quo. The hands are tied. But at least now we can see the ropes. Bibliography For those interested in the primary sources and legal texts that underpin this analysis, the following external resources provide high-trust verification of the claims made above: Goldfarb v. Virginia State Bar, 421 U.S. 773 (1975): The Supreme Court decision that ended the “learned profession” exemption from antitrust laws. Read the Oyez Summary. The Sherman Antitrust Act (15 U.S.C. §§ 1–7): The foundational text of US antitrust law prohibiting restraint of trade. Read the Document at the National Archives. North Texas Specialty Physicians v. Federal Trade Commission (5th Cir. 2008): A key ruling establishing that independent physicians cannot collectively bargain on fees without financial integration. Read the Court Opinion. FTC/DOJ Statements of Antitrust Enforcement Policy in Health Care (1996): The federal guidelines explaining the “Messenger Model” and the narrow exceptions for clinical integration. Read the Guidelines (PDF). The RUC (AMA/Specialty Society RVS Update Committee): The AMA's own description of the committee structure and its role in valuing physician work. Visit the AMA RUC Page. “Special Deal” by Haley Sweetland Edwards (Washington Monthly, 2013): An investigative deep-dive into how the RUC operates and its impact on primary care vs. specialty pay. Read the Investigation. The National Labor Relations Act (NLRA): The law governing the right to unionize, which specifically excludes independent contractors. Read the NLRA. Laugesen, Miriam J. Fixing Medical Prices: How Physicians Are Paid. Harvard University Press, 2016. The definitive scholarly analysis of the RUC's history, structure, and influence on American healthcare pricing. Government Accountability Office. “Medicare Physician Payment Rates: Better Data and Greater Transparency Could Improve Accuracy.” 2015. GAO's critical analysis of RUC methodology and conflicts of interest. Center for American Progress. “Rethinking the RUC.” 2015. Policy analysis of the RUC's structural bias against primary care and cognitive services. Health Affairs Scholar. “Insurance Acceptance and Cash Pay Rates for Psychotherapy in the US.” 2023. Empirical research on out-of-network utilization in mental health care. Medicare Payment Advisory Commission (MedPAC). “Report to the Congress: Medicare and the Health Care Delivery System.” 2024. Annual policy recommendations including proposals for reforming physician fee schedule methodology. Joel Blackstock, LICSW-S, is the Clinical Director of Taproot Therapy Collective in Hoover, Alabama. He specializes in complex trauma treatment and writes at GetTherapyBirmingham.com.  

Ruth S. Shim, M.D., M.P.H., and Alex Shevrin Venet, M.Ed., join Dr. Dixon and Dr. Berezin, along with guest host Dr. Matt Hirschtritt to discuss equity-centered trauma-informed education (ECTIE), a model that can be applied across the educational spectrum. 04:15     Expanding equity-centered trauma-informed education (ECTIE) beyond K–12 05:59    Five core components 10:25    Reception from teachers and school administrators to ECTIE 12:41    Unconditional positive regard 14:22    How did your collaboration begin? 17:29    Medical school and TIE 19:42    Bidirectional nature of ECTIE 22:00    "Asset-based lens instead of a lens of saviorism" 24:45    Take home points on ECTIE Transcript Subscribe to the podcast here. Check out Editor's Choice, a set of curated collections from the rich resource of articles published in the journal. Sign up to receive notification of new Editor's Choice collections. Browse other articles on our website. Be sure to let your colleagues know about the podcast, and please rate and review it wherever you listen to it. Listen to other podcasts produced by the American Psychiatric Association. Follow the journal on Twitter. E-mail us at psjournal@psych.org

Don’t just retire. Design. Join us in our group program. Two new groups starting on January 22 & 23. Don’t put off planning for your life in retirement. Take the first step today. _________________________ What does it truly mean to age well in a world where longevity is increasing, but health spans vary wildly? In this episode, we meet with Dr. Arnold Gilberg, author of The Myth of Aging: A Prescription for Emotional and Physical Well-Being. Dr. Gilberg challenges the traditional definition of retirement, arguing that total withdrawal from professional life can lead to loneliness and decline. Instead, he advocates for “semi-retirement” and finding new ways to stay needed, including his own journey of entering rabbinic training. Tune in to hear his wisdom on adapting your physical fitness as your body changes, the power of self-forgiveness, and why exercising your brain is just as critical as exercising your body. Dr. Arnold Gilberg joins us from Los Angeles. __________________________ Bio Arnold L. Gilberg, MD, PhD, received his bachelor's degree in political science and Doctor of Medicine degree from the University of Illinois. He interned at the Los Angeles General Medical Center. He is the last person alive trained by Franz Alexander, MD, a distinguished colleague of Sigmund Freud. His psychiatric training took place at the  Cedars-Sinai Medical Center, where he was chief psychiatric resident. He also has a doctorate in psychoanalysis from the Southern California Psychoanalytic Institute. Dr. Gilberg is a distinguished life fellow of the American Psychiatric Association, the former clinical chief of psychiatry at Cedars-Sinai Medical Center in Los Angeles, and an associate clinical professor at UCLA School of Medicine (honorary). He served for ten years under three different governors on the Medical Board of California for LA County, and has treated thousands of patients in his Los Angeles-based practice. Today he lives with his wife in LA, where he continues to see patients on a regular basis. ___________________________ For More on Dr. Arnold Gilberg The Myth of Aging: A Prescription for Emotional and Physical Well-Being ___________________________ Podcast Episodes You May Like Shift – Ethan Kross Make Your Next Years Your Best Years – Harry Agress, MD The Good Life – Marc Schulz, PhD ____________________________ About The Retirement Wisdom Podcast There are many podcasts on retirement, often hosted by financial advisors with their own financial motives, that cover the money side of the street. This podcast is different. You'll get smarter about the investment decisions you'll make about the most important asset you'll have in retirement: your time. About Retirement Wisdom I help people who are retiring, but aren't quite done yet, discover what's next and build their custom version of their next life. A meaningful retirement doesn't just happen by accident. Schedule a call today to discuss how the Designing Your Life process created by Bill Burnett & Dave Evans can help you make your life in retirement a great one — on your own terms. About Your Podcast Host Joe Casey is an executive coach who helps people design their next life after their primary career and create their version of The Multipurpose Retirement.™ He created his own next chapter after a 26-year career at Merrill Lynch, where he was Senior Vice President and Head of HR for Global Markets & Investment Banking. Joe has earned Master's degrees from the University of Southern California in Gerontology (at age 60), the University of Pennsylvania, and Middlesex University (UK), a BA in Psychology from the University of Massachusetts at Amherst, and his coaching certification from Columbia University. In addition to his work with clients, Joe hosts The Retirement Wisdom Podcast, ranked in the top 1% globally in popularity by Listen Notes, with over 1.6 million downloads. Business Insider recognized Joe as one of 23 innovative coaches who are making a difference. He's the author of Win the Retirement Game: How to Outsmart the 9 Forces Trying to Steal Your Joy. __________________________ Wise Quotes On Retirement “Retirement is very loosely defined. And for some people, retirement is going from working six days a week to working four days a week. And people think, oh boy, I’m really retired. I’m working less. And especially if you like your job. And I think people who really like their work and what they’re doing should seriously consider whether retirement, total retirement, is something they want to do. Because for most professions or work, people don’t have to completely retire. They can semi-retire and work two or three days a week if that potential is given to them. Take, for example, myself. I don’t feel like really completely retiring. I’m proud of the fact that I’m 89 years old, and I still work a couple of days a week seeing patients because I like what I do. It makes me feel needed. And the hospital that I attend at tells me I can’t retire. Well, let’s talk about myself. I think my working allows me to remain involved, sing patients, sing other professionals, engaged in some teaching. And we know that people struggle with loneliness. And I do address that in my book The Myth of Aging. There’s a recent study that came out that in the United States today, one out of three people are lonely, which leads to depression, leads to anxiety, leads to psychiatric problems, leads to suicide, leads to drug abuse, and a variety of other condition. So the idea that a person remains engaged in their profession in some way is very critical, and people need to seriously take a look at their retirement, or if they are going to retire, what they might do following their retirement.” On Adapting “We all continue to adapt. And I think recognizing that is important. And also not beating up on yourself about these adaptations that take place. People don’t forgive themselves and people are always ready to jump on themselves. And we need to understand that this type of adaptation is very, very important and to accept it and be grateful for it. I enjoyed running marathons, Los Angeles primarily, and it’s nice for me to hold on to the memory, but I’m not really there anymore. I’m in a different place. I’m happy that I can go to our gym and exercise for 25 or 30 minutes, you know, and come up fatigued. And I feel good about that. And my wife feels similarly. We’re both at that place and we enjoy the fact that we can at least do this.” On Doing Something New “Well, for most people, I think trying to find something new to do, especially after you’re retired, is very critical for cognitive brain functioning because it keeps your mind at work. And we know today, neurologically, that people need to exercise their brain just as they exercise the rest of their body. So people who retire and find something new to do are helping themselves. I must say there is a small segment of the population who enjoy being retired, moving to a cabin in Northern California or Montana, and being very satisfied in that life situation. But for most of us, that doesn’t work. And so for me, I’ve always had an attachment to faith and spirituality, which I think ultimately provides people with a sense of community.”

In this episode of Get Psyched, we're joined by Dr. Mark Rapaport, 2025 President-Elect of the American Psychiatric Association and one of the most influential academic leaders in modern psychiatry.Dr. Rapaport has had a distinguished career spanning several of the nation's leading institutions. He has served as CEO of the Huntsman Mental Health Institute and Chair of the Department of Psychiatry at the Spencer Fox Eccles School of Medicine at the University of Utah; Chair of Psychiatry and Behavioral Sciences at Emory University School of Medicine; Chief Psychiatric Officer for Emory Healthcare; founding Co-Director of the Emory Brain Health Center; Chair of Psychiatry and Behavioral Neuroscience at Cedars-Sinai Medical Center; and Vice Chair of Psychiatry at the David Geffen School of Medicine at UCLA.In addition to his leadership roles, Dr. Rapaport is a highly accomplished researcher with more than 200 peer-reviewed publications. He also co-founded and served as Editor-in-Chief of FOCUS: The Journal of Lifelong Learning in Psychiatry, guiding the journal to address emerging clinical topics — including being the first major psychiatric journal to devote an entire issue to LGBTQ+ and underrepresented minority health concerns.In our conversation, Dr. Rapaport reflects on his upbringing, his family's multigenerational legacy in medicine, and the mentors and patients who shaped his path into psychiatry. We discuss his philosophy of leadership, his passion for academic medicine, and the sometimes winding journey of following one's curiosities across research, teaching, and clinical care.Whether you're a medical student, psychiatry trainee, or clinician thinking about leadership, advocacy, or academic medicine, this episode offers an inspiring and thoughtful look at a career devoted to service, mentorship, and advancing the field. Thank you for listening!We are recruiting for several open roles on the Get Psyched podcast team (Editor, Host, Writer, Producer). Here is the application link:https://docs.google.com/forms/d/e/1FAIpQLSfFL4UapBbRxGWiL-V8KNQZslkZF-Gnzf2zI16cNoreGcEmXA/viewform?usp=sharing&ouid=111781906299228250953Music from #Uppbeat (free for Creators!):https://uppbeat.io/t/cruen/city-streetsLicense code: 2JJVCBQKEE2GJH5N

Dr. Julia Linke (University of Mainz, Germany) joins AJP Audio to discuss the use of neural efficiency, a measure of brain activity, as a potential biomarker in the treatment of children with anxiety disorder.  Afterwards, AJP Editor-in-Chief Dr. Ned Kalin joins the podcast to put the rest of the issue into context. 00:31   Linke interview 02:15   State or a trait? 04:15   Neural efficiency and CBT 05:22   Potential as a biomarker 07:08   Patient-rated and parent-rated measures of anxiety 08:16   Immediate clinical implications 09:50   Limitations 10:43   Future directions of research 11:44   Kalin interview 11:50   Linke et al. 15:16   Mallard et al. 18:11   Naples et al. 21:44   Mac Giollabhui et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

This episode comes out the day after Christmas, when many of us are surrounded by more stuff, more noise, and more overwhelm. In this episode, we talk about how clutter is not just physical. It can show up in our thoughts, our emotions, and even our schedules. We explore how rumination and constant busyness can keep the nervous system stuck in stress, and why clearing space in your environment and your calendar can support healing after breast cancer. Using research from the American Psychiatric Association, we take a deeper look at rumination, emotional attachment, and how mindset work is a foundational part of whole body healing. This episode is also an invitation to consider how you want to use your time in the next season of life and whether it is time to clear space for yourself.   Let's Connect! If this episode helped you breathe a little easier, please share it with a friend or leave a review. Every share helps spread this message of hope, healing, and whole-person wellness.

Welcome to The Mental Breakdown and Psychreg Podcast! Today, Dr. Berney and Dr. Marshall discuss the differences between personality traits and personality types, and explain how personality traits contribute to our current model of personality disorders. Read the articles from the American Psychiatric Association here and from Authentically Emily here. You can now follow Dr. Marshall on twitter, as well! Dr. Berney and Dr. Marshall are happy to announce the release of their new parenting e-book, Handbook for Raising an Emotionally Healthy Child Part 2: Attention. You can get your copy from Amazon here. We hope that you will join us each morning so that we can help you make your day the best it can be! See you tomorrow. Become a patron and support our work at http://www.Patreon.com/thementalbreakdown. Visit Psychreg for blog posts covering a variety of topics within the fields of mental health and psychology. The Parenting Your ADHD Child course is now on YouTube! Check it out at the Paedeia YouTube Channel. The Handbook for Raising an Emotionally Health Child Part 1: Behavior Management is now available on kindle! Get your copy today! The Elimination Diet Manual is now available on kindle and nook! Get your copy today! Follow us on Twitter and Facebook and subscribe to our YouTube Channels, Paedeia and The Mental Breakdown. Please leave us a review on iTunes so that others might find our podcast and join in on the conversation!

Jeffrey welcomed Sara Lurie, Chief Executive Officer, Community Mental Health Authority of Clinton, Eaton, Ingham Counties Can you explain the kinds of services the new Crisis Care Center will offer? How does the new Crisis Care Center reflect CMHA-CEI's long-term vision for behavioral health care in our region? What's something you wish more people understood about seeking support for mental health, especially before it becomes a crisis? We know the holidays can be both joyful and difficult. How is CMHA-CEI meeting people where they are emotionally during this season, and why is that important now? How does CMHA-CEI work to make mental health care feel more accessible and less intimidating, including for families and young people? » Visit MBN website: www.michiganbusinessnetwork.com/ » Subscribe to MBN's YouTube: www.youtube.com/@MichiganbusinessnetworkMBN » Like MBN: www.facebook.com/mibiznetwork » Follow MBN: twitter.com/MIBizNetwork/ » MBN Instagram: www.instagram.com/mibiznetwork/ HOPE BEYOND WINTER BLUES: Behavioral health center is a guiding light for 2026 A guiding light for Lansing: Crisis Care Center progress offers reassurance during winter months Construction advances on a cornerstone mental health resource and investment for the region LANSING, Mich. — As winter settles across the region, the season brings both reflection and renewed focus on community well-being. Construction continues on the Community Mental Health Authority of Clinton, Eaton, and Ingham Counties' (CMHA-CEI) Crisis Care Center—a project grounded in compassion and designed to expand access to fundamental mental health support, bringing warmth and hope as 2025 draws to a close and the community's shared vision for a brighter 2026 approaches. The center's progress shines vividly, reflecting the community's ongoing investment in healing, connection and care for all. As the season of togetherness returns, it can also bring quiet reminders of loneliness or unspoken struggles. For some, the contrast between festive expectations and personal reality can intensify emotional and mental health challenges. When school is on break and routines are disrupted, families often lose access to the daily support systems they rely on, making timely, accessible behavioral health care even more essential. In those moments, CMHA-CEI's existing crisis services for all ages offer immediate, around-the-clock support and will continue to be accessible during a difficult season for resources. The Crisis Care Center stands as a guiding light for the year ahead, expanding support, access and stability for the community in 2026. “This season reminds us how essential it is to have accessible, safe and welcoming spaces for healing,” said Sara Lurie, CEO of CMHA-CEI. “Our community is coming together to offer renewed hope by responding with compassion, innovation and action.” Nearly one in three Americans experience increased holiday stress, and a quarter report worsened mental health during the season, according to the American Psychiatric Association. Top stressors include financial pressures, grief and difficult family dynamics. As the days shorten, “winter blues,” or seasonal depression, can set in, with reduced sunlight disrupting sleep and mood, deepening winter's emotional toll. Even when it doesn't feel like an emergency, individuals experiencing these or other mental health challenges can access support now. CMHA-CEI's Access Center provides same-day assessments and connects individuals to services tailored to their needs. Care is available to everyone in the community, with or without insurance. ### About Community Mental Health Authority of Clinton, Eaton, and Ingham Counties (CMHA-CEI): The Community Mental Health Authority of Clinton, Eaton, and Ingham Counties (CMHA-CEI) provides a comprehensive range of person-centered, high-quality behavioral health, substance use, and developmental disability services to residents in the region.

Welcome to The Mental Breakdown and Psychreg Podcast! Today, Dr. Berney and Dr. Marshall discuss the various factors that contribute to the development of our personality. Read the articles from the American Psychiatric Association here and from the Mayo Clinic here. You can now follow Dr. Marshall on twitter, as well! Dr. Berney and Dr. Marshall are happy to announce the release of their new parenting e-book, Handbook for Raising an Emotionally Healthy Child Part 2: Attention. You can get your copy from Amazon here. We hope that you will join us each morning so that we can help you make your day the best it can be! See you tomorrow. Become a patron and support our work at http://www.Patreon.com/thementalbreakdown. Visit Psychreg for blog posts covering a variety of topics within the fields of mental health and psychology. The Parenting Your ADHD Child course is now on YouTube! Check it out at the Paedeia YouTube Channel. The Handbook for Raising an Emotionally Health Child Part 1: Behavior Management is now available on kindle! Get your copy today! The Elimination Diet Manual is now available on kindle and nook! Get your copy today! Follow us on Twitter and Facebook and subscribe to our YouTube Channels, Paedeia and The Mental Breakdown. Please leave us a review on iTunes so that others might find our podcast and join in on the conversation!

Do you get seasonal depression during the cold and dark times of year? According to the American Psychiatric Association, as many as 4 in 10 Americans said they have experienced declining moods during the winter months. ABC News Correspondent Jim Ryan joined the show to analyze the data from the study and highlight what factors are contributing to these winter depressions many go through. 

Dr. Suresh Durgam (Intra-Cellular Therapies, a Johnson & Johnson Company, Bedminster, NJ) joins AJP Audio to discuss a phase 3 randomized controlled trial looking at the use of the antipsychotic medication lumateperone as adjunctive to antidepressant therapy in the treatment of patients with major depressive disorder. Afterwards, AJP Editor-in-Chief Dr. Ned Kalin discusses the rest of the December issue of the Journal. 00:48   Durgam interview 03:09   Mechanism of action 04:44   Patient-reported outcomes 06:31   Immediate clinical implications 07:32   Limitations 08:08   Further research 09:25   Kalin interview 09:38   Durgam et al. 13:09   Lin et al. 17:22   Brodsky et al. Transcript Be sure to let your colleagues know about the podcast, and please rate and review it on Apple Podcasts, Google Podcasts, Spotify, or wherever you listen to it. Subscribe to the podcast here. Listen to other podcasts produced by the American Psychiatric Association. Browse articles online. How authors may submit their work. Follow the journals of APA Publishing on Twitter. E-mail us at ajp@psych.org

Liz and Rebecca cover Chiles v. Salazar, the case before the Supreme Court seeking to strike down a Colorado law banning mental health professionals from practicing "conversion therapy" on children. They explain the details of the case and discuss the hypocrisy of a ruling striking down the ban. They also recount the October 7th oral arguments, where the majority of justices signaled support for a ruling that will nullify state laws in half the country protecting LGBTQ youth from these discredited harmful practices.   Background Oral argument transcript Tenth Circuit Opinion  SCOTUSblog page Amicus briefs Americans United FFRF SCOTUSblog - "Does Colorado's "conversion therapy" ban violate free speech?" The Trevor Project - "Chiles v. Salazar: What you need to know about the U.S. Supreme Court case on conversion therapy" The American Psychiatric Association's position on conversion therapy  The American Psychological Association's position on conversion therapy The American Medical Association's position on conversion therapy  "LGBTQ Policy Spotlight: From Conversion "Therapy" Laws Protecting LGBTQ Youth" Check us out on YouTube, Instagram, Facebook, Bluesky, and X. Our website, we-dissent.org, has more information as well as episode transcripts.

Dr. Muhamad Aly Rifai is a highly respected internist and psychiatrist serving the Greater Lehigh Valley, Pennsylvania. As the CEO and Chief Psychiatrist and Internist of Blue Mountain Psychiatry, he leads with expertise and dedication to mental health and internal medicine. He also holds the distinguished title of Lehigh Valley Endowed Chair of Addiction Medicine, further solidifying his authority in the field.Dr. Rifai is Board Certified in multiple specialties, including Internal Medicine, Psychiatry, Addiction Medicine, and Psychosomatic Medicine, demonstrating his extensive knowledge and commitment to comprehensive patient care. His professional achievements have earned him recognition as a Fellow of the American College of Physicians, the Academy of Psychosomatic Medicine, and the American Psychiatric Association. Additionally, he has served as the President of the Lehigh Valley Psychiatric Society, contributing significantly to the advancement of psychiatric practice in the region.Learn more: http://www.alyrifai.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-dr-muhamad-aly-rifai-ceo-chief-psychiatrist-and-internist-of-blue-mountain-psychiatry

Dr. Muhamad Aly Rifai is a highly respected internist and psychiatrist serving the Greater Lehigh Valley, Pennsylvania. As the CEO and Chief Psychiatrist and Internist of Blue Mountain Psychiatry, he leads with expertise and dedication to mental health and internal medicine. He also holds the distinguished title of Lehigh Valley Endowed Chair of Addiction Medicine, further solidifying his authority in the field.Dr. Rifai is Board Certified in multiple specialties, including Internal Medicine, Psychiatry, Addiction Medicine, and Psychosomatic Medicine, demonstrating his extensive knowledge and commitment to comprehensive patient care. His professional achievements have earned him recognition as a Fellow of the American College of Physicians, the Academy of Psychosomatic Medicine, and the American Psychiatric Association. Additionally, he has served as the President of the Lehigh Valley Psychiatric Society, contributing significantly to the advancement of psychiatric practice in the region.Learn more: http://www.alyrifai.com/Influential Entrepreneurs with Mike Saundershttps://businessinnovatorsradio.com/influential-entrepreneurs-with-mike-saunders/Source: https://businessinnovatorsradio.com/interview-with-dr-muhamad-aly-rifai-ceo-chief-psychiatrist-and-internist-of-blue-mountain-psychiatry

Do you have a teen who feels everything deeply—who's easily overwhelmed, deeply compassionate, or just needs more downtime than others?Have you ever wondered whether your child's sensitivity is actually a superpower rather than a weakness? In this heartfelt conversation, Dr. Judith Orloff, psychiatrist, empath, and New York Times bestselling author, joins Colleen O'Grady to explore how parents can understand and support their highly sensitive teens. Dr. Orloff shares how sensitivity and empathy—often misunderstood—are powerful traits that can help teens grow into caring, grounded adults when they have the right support. From defining what it means to be an empath, to setting healthy emotional boundaries, to helping sensitive teens manage overwhelm, Dr. Orloff offers practical wisdom for parents and heartfelt encouragement for anyone raising a deeply feeling child. Together, Colleen and Dr. Orloff discuss how sensitivity can be both a gift and a challenge, and how moms can nurture these qualities without taking on too much themselves. Guest Bio: Dr. Judith Orloff Dr. Judith Orloff is a psychiatrist on the UCLA Psychiatric Clinical Faculty and a New York Times bestselling author whose books include The Genius of Empathy, The Empath's Survival Guide, and her newest children's book, The Highly Sensitive Rabbit. She specializes in helping highly sensitive people and empaths thrive in an often overwhelming world. Dr. Orloff has spoken at the American Psychiatric Association, Google, Fortune's Most Powerful Women Summit, and TEDx, and her work has been featured in The New York Times, O, The Oprah Magazine, USA Today, Teen Vogue, and Scientific American. Learn more at DrJudithOrloff.com.

In the 3rd installment of our Possession Series, we turn to one of the most controversial figures to bridge psychology and the paranormal: Dr. M. Scott Peck, psychiatrist, best-selling author of The Road Less Traveled, and—later in life—a reluctant believer in demonic possession.This episode explores how Peck's clinical background shaped his approach to exorcism, the patients who challenged his skepticism, and the ways he sought to reconcile science, faith, and evil. We'll look at his case studies, his insistence that genuine possession is rare, and his cautionary stance toward both blind belief and total disbelief. Then we'll ask what his work means for modern discussions of mental health, spirituality, and the human shadow.

On July 21st 2025, the FDA convened a hearing on maternal use of antidepressants during pregnancy and the impact this use has on fetal development. Around 400,000 children in the United States are born each year whose mothers took antidepressants while pregnant, and so it's easy to see the societal importance of this topic. What are the risks to the fetus, the newborn, and the long-term development of that child? Adam Urato and Joanna Moncrieff were members of that FDA panel, and so too were several others well-known to MIA readers, including David Healy and Joseph Witt-Doerring. The purpose of the panel was to assess whether the FDA needed to put a warning on antidepressants related to their use in pregnancy, and most on the panel spoke of research that told of the need to do so. However, after the panel concluded, the American Psychiatric Association and other medical associations, most notably the American College of Obstetricians and Gynecologists, responded with what can only be described as howls of outrage, issuing press releases and telling the public that the panel was biased and that the real risk during pregnancy was untreated mental illness. These medical organizations asserted that the increased risk of adverse outcomes for children born to depressed mothers is due to the illness and not the drug, and that there was plenty of evidence that antidepressants were a helpful and even life-saving treatment for maternal depression. Here is where we are today. That FDA hearing put two narratives on public display, and most media reports embraced the narrative put forth by the medical organizations. What we will do today is review the evidence that exists on this topic and the response by the medical guilds to a public airing of that evidence. Dr. Adam Urato is Chief of Maternal and Fetal Medicine at the Metro West Medical Center in Framingham, Massachusetts, and he has been speaking and writing about the risk of medications used during pregnancy for years. Dr. Joanna Moncrieff is a UK psychiatrist and researcher who was a co-founder of the Critical Psychiatry Network and is well known for her research on the safety and efficacy of psychiatric drugs. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. https://www.madinamerica.com/donate/ To find the Mad in America podcast on your preferred podcast player, click here: https://pod.link/1212789850 © Mad in America 2025. Produced by James Moore https://www.jmaudio.org

Today we're diving into the world of empaths and highly sensitive people—what it means to be one, what makes it complicated, and why it's also such a gift. My guest, psychiatrist, author, and empath Dr. Judith Orloff, shares her own journey as a highly sensitive child and how it shaped her work as a psychiatrist. We talk about the science behind sensitivity, how to recognize a highly sensitive child, and why self-care and co-regulation are so critical for both parents and kids. Judith also touches on bullying, sensory overload, and the strategies empaths can use to thrive—and she introduces her beautiful new children's book, The Highly Sensitive Rabbit, created to help kids understand and embrace their sensitivity.   About Judith Orloff, MD Judith Orloff, MD, is a psychiatrist who serves on the UCLA Psychiatric Clinical Faculty and an empath. She is a New York Times bestselling author whose most recent books are The Genius of Empathy (2024) and The Empath's Survival Guide (2017). Specializing in treating highly sensitive people in her private practice, she also offers Empathy Training Programs to organizations. She has spoken at the American Psychiatric Association, Google, Fortune's Powerful Women's Summit, and TEDx. She has appeared on The Today Show, CNN, PBS, and NPR. Her work has been featured in The New York Times, O, The Oprah Magazine, USA Today, Teen Vogue, and Scientific American. Things you'll learn from this episode How Dr. Orloff blends traditional psychiatric expertise with her lived experience as an empath Why empaths and highly sensitive individuals often struggle with sensory overload and emotional stress from others How co-regulation between parents and children supports emotional health and resilience Why parents need to advocate for highly sensitive kids in schools, especially in the face of bullying How recognizing the gifts of empathy—like deep connection to nature and beauty—helps children embrace who they are Why self-empathy and intentional self-care practices are essential for empaths to thrive Resources mentioned Dr. Judith Orloff's website The Highly Sensitive Rabbit by Dr. Judith Orloff The Empath's Survival Guide: Life Strategies for Sensitive People by Dr. Judith Orloff Thriving as an Empath by Dr. Judith Orloff Dr. Judith Orloff on Facebook Dr. Judith Orloff on X Dr. Judith Orloff on LinkedIn Dr. Judith Orloff on YouTube Dr. Judith Orloff on Instagram Learn more about your ad choices. Visit podcastchoices.com/adchoices

Today, in 2025, there are numerous mental health professionals on television and streaming podcasts who talk openly about the state of President Trump's mental health. They don't pull any punches, given the ample evidence from his public appearances and his frequent online diatribes. They say he has a personality disorder, that he's an antisocial malignant narcissist who's in serious cognitive and physical decline. The irony is that, back when I recorded this interview with forensic psychiatrist Dr. Bandy X. Lee, she and the other 27 contributors to their 2017 book The Dangerous Case of Donald Trump knew that they would be accused of violating the American Psychiatric Association's "Goldwater Rule." This principle states that psychiatrists are prohibited from offering opinions on the mental state of individuals that they have not personally evaluated.  This rule was created after, in 1964, Fact magazine published a survey asking psychiatrist to state whether they thought presidential candidate Barry Goldwater was psychologically fit to be President. The survey's results led to widespread ethical concerns and public outcry, prompting the APA to develop a formal set of ethics rules for its members. However, in her book and in the part of our conversation that was unfortunately edited out, Dr. Lee asserted that if a mental health professional saw someone publicly and repeatedly displaying behavior that gave her or him cause for concern, they have every right to sound the alarm, even ask the authorities to put the person in a 72-hr involuntary hold for evaluation. But Yale Medical School and the courts did not agree with her, and she was shown the door.  That was just 3 years ago. And yet, as I stated up front, mental health professionals are publicly calling out Trump's mental health problems and not suffering any consequences. As you listen to Dr. Lee, I think you'll agree that she and the other writers correctly described and predicted the how problematic it would be if Trump were put in power.

What if there were chemicals in the air and energy charges in the ground that benefit your brain for better clarity and protection against mental illness? This is what today's guest has written about in his research and why his prescriptions for better mental health include nature, food, movement, and gratitude.In this episode I'm joined by Dr. Drew Ramsey, board-certified psychiatrist, author, and pioneer in nutritional psychiatry, to talk about how we can strengthen our mental fitness in today's world.We explore:

Research shows that developing a daily routine can positively impact mental health by creating a structure that helps reduce stress and anxiety. Mental health counselor Samantha Zhu explains how to create and stick to a routine.And, exercise improves not only physical health, but mental health too. It can be hard to start a fitness regimen, but fitness instructor Aubre Winters shares some tips for working regular exercise into your life.Then, according to the American Psychiatric Association, more than 30% of Americans say their sleep quality is poor, or they aren't getting enough sleep each night. Psychologist Shelby Harris details how to create morning and bedtime routines that can help you get more restful sleep.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Ask David-- The Fear of Happiness! Although we had five questions for today's Ask David episode, we spend the entire podcast on the first question from a man with an intense fear of happiness. He wrote: How can I use exposure to overcome my fear of happiness? Hi David, How would you do exposure for the fear of happiness? Whenever I feel happy I immediately feel afraid because I had a very strict religious upbringing where many harmless forms of fun and enjoyment were completely forbidden. Even though I'm no longer a religious believer, the fear remains. Feeling good then makes me afraid, anxious and insomniac. This often goes on for days after something good happens and it almost seems as if I AM being punished after all! How can I recover when feeling good makes me feel so bad? Love your work and all that you do. Best regards, Tomas David's reply As I have said on numerous occasions, I do NOT recommend “methods” (like exposure) for “problems” (like your “fear of happiness.”) I think your problem is very treatable, but I work with patients systematically, and that doesn't mean starting out with a “method,” like exposure or any other method. I use a step by step approach, using T = Testing, E – Empathy, A = Assessment of Resistance, and M = Methods in a sequence. In addition, when I work with anxiety, I always incorporate these four approaches with every patient I work with: The Motivational Model: I bring Outcome and Process Resistance to conscious awareness and melt them away, if possible, using a variety of TEAM CBT approaches. The Cognitive Model: This involves a well-done Daily Mood Log to identify and challenge the distorted negative thoughts at one moment in time. The Exposure Model: Facing your fears, or testing them with an experiment. This is frightening, but required of every anxious patient. The Hidden Emotion Model: This is based on the idea that only “nice” people struggle with anxiety, with only a few exceptions, and that an unacknowledged problem is often hiding right behind the anxiety. The cure requires the Detective Step: identifying what the hidden emotion or feeling is. The Action Step: Expressing the suppressed feeling and or dealing with the problem you are avoiding. Your fear of happiness is an interesting problem for sure. One of my favorite movies, “Babette's Feast,” involves this theme. If you want some help, you could send me a partially completed Daily Mood Log. You will discover that you are the only one who is doing the punishing! It is that belittling, intimidating voice in your own head that is causing 100% of your suffering. I look forward to helping you challenge those voices! In the meantime, I'll add this to the latest Ask David podcast questions, in the hopes you might send the DML, and then Rhonda and I can comment in greater depth on the live program. Best, david Tomas kindly sent a Daily Mood Log, which you can see if you CLICK HERE As you can see, the Upsetting Event is simply “studying mathematics,” something he loves. However, he has the belief that if he allows himself to enjoy this or any activity, something terrible will happen to him. He traces this to a strict religious upbringing, and perhaps also to bullying he endured as a kid. You can see that this is intensely upsetting to him. If you look you will see that in 8 of the 9 categories of emotions on his Daily Mood Log (DML), he scores in the range of 80 to 100, which is intense and severe to extreme. The only emotion category that is not extremely elevated is the anger cluster, which he rated at only 40. You can see as well that his negative thoughts all involve the theme of punishment and destruction if he allows himself to feel happiness and enjoyment of life, or if he advances himself in life. In some of the emails he sent me, he traces this back to being bullied when young. . . possibly by kids who were jealous of his high IQ. As mentioned above, I don't throw methods (like exposure) at people based on a problem or diagnosis (in his case a phobia, the fear of happiness.) I also mentioned that I go through the T E A M model in a sequence, starting with Testing and Empathy, followed by the Assessment of Resistance and culminating in Methods. In addition, I always treat anxious patients with four powerful models, including the Motivational Model, the Cognitive Model, the Exposure Model, and the Hidden Emotion Model. I described these models above. The Motivational Model The Outcome Resistance has to do with the fact that Tomas may resist treatment because of his fear of the consequences of successfully achieving happiness. We will deal with that with Positive Reframing, including the Miracle Cure Question, the Magic Button, Positive Reframing, and the Magic Dial. In addition, we'll have to deal with Process Resistance. At some point, we will have to use exposure techniques, and we will want to find out if he's WILLING to do exposure even though it may be extremely anxiety provoking at first. We can dangle the carrot, letting him know that we anticipate a positive outcome, but also understand that facing his worst fears may be terrifying at first, and very uncomfortable. I will not try to persuade him to use any of the many versions of Exposure. He will have to persuade me that he's willing to do it. I suspect he will be, because he is asking for exposure, but if he says he wants to be treated without exposure, I will have to let him know I am not a good choice as a therapist for him! That's because I don't know how to defeat any form of anxiety without exposure. Of course, I cannot treat Tomas, or anyone, through an Ask David, but can only make teaching points. But I am teaching self-help techniques that have been helpful to many people. In an email, I asked him the Magic Button question, and he said he didn't think he'd push it. This indicates some understandable resistance that has to be dealt with. Positive Reframing is one way to deal with Outcome Resistance. The goal is not only deeper empathy but also helping patients “see” that the negative thoughts and feelings they are struggling so desperately to overcome are actually positive in many ways. Once they “see” this, it is kind of a pleasant shock to the system, and their resistance to change typically disappears. Then we ask them to set goals for each negative feelings—a lower level of each feeling that would allow them to feel better and not lose all the wonderful positives we have discovered. That's why it's better NOT to push the Magic Button. To help Tomas or anyone see and list the positives in their negative thoughts and feelings, we ask two key questions about each one: What are some possible advantages, or benefits, of this negative thought or feeling? How might it help me? What does this negative thought or feeling show about me and my core values as a human being that's positive and awesome? Typically, this leads to list of 10 to 20 positives that have three characteristics. To give you an example, his intense loneliness is an expression of his love for people and the great value he sees in meaningful relationships. And his anxiety serves to protect him from danger, and is therefore an expression of self-love. And his feelings of inferiority—in spite of his tremendous intelligence—show humility, which is not only a spiritual quality, but also can make a person of great intelligence more accessible, more vulnerable, and more attractive. Inferiority may also be an expression of his honesty and willingness to acknowledge his shortcomings, as well as his accountability. We could easily go on and on, and it might be a great exercise for you to try find the positives in several other of his negative thoughts and feelings by asking those two questions. Once my patient and I have listed 10 or more positives, I ask if these positives are True and valid? Powerful? Important? Nearly always, I get a resounding YES to each question. Then I use the Magic Dial to see what they might want to dial each negative feeling down to in the % Goal column of the Daily Mood Log. Is this Positive Reframing process straightforward? Easy? Not really. I make it look easy, because when I teach I want people to understand, but “seeing” these positives is, in reality, incredibly challenging for most people. In fact, You can see the Positive Reframing that Tomas completed on his own if you CLICK HERE As you can see Tomas almost completely missed the boat when he tried to identify the positives in his negative thoughts and feelings. I mention this because it is a CRUCIAL step in TEAM CBT, and people often have a tremendously hard time “seeing” the positives in their negative thoughts and feelings. A big part of the reason is that society teaches us the opposite. In fact, negative feelings are Labeled as a bewildering array of more than 200 so-called “mental disorders” by the American Psychiatric Association in their “bible,” the DSM (Diagnostic and Statistical Manual of Mental Disorders.) But here's something even MORE surprising. Rhonda—a highly respected and admired TEAM CBT therapist and teacher—also struggles to find the positives during today's podcast. Once someone has pointed them out, you can suddenly “see” them. But on your own, you may have a lot of trouble at first with Positive Reframing, which is anything but simple, but extraordinarily powerful once you “get it.” I recently told my weekly Tuesday psychotherapy training group at Stanford that TEAM CBT is extraordinarily difficult to learn and master—nearly always requiring years of study and practice—and perhaps the most challenging form of psychotherapy ever developed. She was angry and told me I'd have to do large controlled outcome studies to validate that claim! Yikes! I may be wrong, and there could be other more difficult forms of therapy, but I still believe what I'm saying because I see it every single day. Many of the most powerful and helpful concepts, such as the four “Great Deaths” of the “self” for the therapist and for the patient in TEAM, and the Acceptance Paradox, and more are hard to learn! But worth it, IF you take the time to learn this method. And if you wish to use TEAM CBT, on yourself (for self-help) or with your patients (if you're a therapist) you will have much greater success after you master this powerful but elusive skill. The Cognitive Model After Rhonda and I worked with Positive Reframing, we went on to the technique that usually starts the M = Methods section, called “Explain the Distortions.” This powerful method includes answering three questions about one or several of the distortions you can find in one of the thoughts you want to work on first. First, select the thought and identify all the distortions in it, listing them by abbreviations in the Distortion column on your Daily Mood Log. For example, if it is an example of All-or-Nothing you can put AON in that column. And you can put OG for Overgeneralization, and so forth. Often, you will find five or even ten distortions in a single negative thought. Let's say you work on, “If I'm happy, I'll be destroyed.” This alarming thought includes AON; LAB, FT, DP, and ER. And it's also a Hidden SS. Choose the distortion you want to work on first. Let's say it's Fortune Telling (FT). Why is this distortion, FT, considered a thinking error in general? Why does the FT distortion your specific thought pretty much make the thought unreasonable? In other words, Why does the FT in your thought NOT map onto reality? And finally, why is the FT is this thought unfair? As an exercise, turn off the podcast for a moment and write down your answers to those three questions. Once you're done, you can check the answers at the end of the show notes. It's a great skill to practice and learn, because it will usually make it really easy for you to generate positive thoughts that satisfy the necessary and sufficient conditions for emotional change. Do you know what they are? Write them down before you look at the answers at the end of the show notes. Just take a guess, but WRITE SOMETHING DOWN before you look! But DON'T look until you've written down your own answers! Hey, did you peek, or did you write down the answers first? I get it! And I forgive you! However, you missed out on a great opportunity for learning if you skipped the written exercise. Or, to put it positively, I try to make the exercises fun and interesting. And if you do them, you'll learn some cool and helpful things rapidly. It's like riding a bicycle. You've got to get on and ride to learn how to do it! But here's what's really interesting. You'll notice that Rhonda, once again, really struggles with this exercise during the podcast. Although I think of Explain the Distortions as a really easy TEAM CBT method, experience with real people has over and over again provided abundant evidence that it's NOT easy for many, or possibly most, people at first. So, what's the point? Here's the point. If you're a therapist, this method is powerful, and will richly reward you for the time and effort you spend in learning how to do it! But you cannot take it for granted if you want to use it in an actual therapy session. And if you are simply looking for self-help, the exact same thing is true: the method is incredibly helpful and well worth some time and effort to “get it!” In addition, to challenging the obviously distorted thoughts on his Daily Mood Log, what other methods might be helpful to Tomas? The Exposure Model Well, there are a great many, including the Exposure techniques he was asking for. For example, he could intentionally make himself happy, and then fantasize some horrible punishment using Cognitive Flooding. The idea would be to make himself as anxious as possible for as long as possible, until he finally gets bored with the fantasy, which will definitely happen eventually, and the anxiety disappears. Exposure is terrifying at first, and it is supposed to be. That's whey and how it works! The Hidden Emotion Model There are many helpful variations on the Exposure front, and the Hidden Emotion Model might also be key. Is there some problem or issue in his life that Tomas is not dealing with? The Class on this technique in the (now entirely free for the summer of 2025 app) Feeling Great app has many details and exercises and examples to show how this mind-blowing technique works. That's it for today's podcast. I want to thank you, Tomas, for providing us with a fascinating problem, and all of you who send in your questions. We are SO GRATEFUL that you are bouncing back, Rhonda, after your ordeal with radiation therapy for your lymphoma, and send you all our love and best wishes for joyful and complete healing and liberation from your nightmare! Warmly, Rhonda and David Answers Here is my answer to first exercise on the necessary and sufficient conditions for emotional change from a positive thought. . The necessary condition for emotional change: The Positive Thought must be 100% correct. The sufficient condition for emotional change: The Positive Thought must reduce your belief in the disturbing negative thought. Sometimes you'll want to reduce it all the way to zero. Sometimes, that's not necessary, especially with Should Statements. Here are my answers to the three questions about Explain the Distortions above. In general, FT is a thinking error when you are making arbitrary alarming predictions without strong evidence that supports those predictions. In particular, there is no evidence that supports the claim that people who feel happy rapidly become the victims of some horrific disaster or punishment. This thought is very unrealistic because the ONLY punishment that Tomas has experienced is the result of his own negative thoughts! This thought is unfair because it puts Tomas in handcuffs so he will be unable to enjoy his life.

What if death isn't the end but a doorway to something far greater? Dr. Bruce Greyson, M.D. (author of After, Chester Carlson Professor Emeritus of Psychiatry at the University of Virginia, and co-founder of the International Association for Near-Death Studies) shares the near-death experience (NDE) that shattered his medical skepticism and launched decades of consciousness research. A Distinguished Life Fellow of the American Psychiatric Association, Greyson explores astonishing cases of tunnel visions, otherworldly reunions, and the powerful, peer-reviewed scientific evidence for life after death. Could it be that consciousness exists outside the brain? Discover why many say NDEs eliminate the fear of dying, trigger lifelong transformation, and may even unlock hidden psychic abilities. Plus: the surprising connection between trauma, psychedelics, and reincarnation science—and what it all reveals about what happens after we die. Dr. Bruce Greyson's book, After: A Doctor Explores What Near-Death Experiences Reveal about Life and Beyond: https://www.brucegreyson.com/after-a-doctor-explores-what-near-death-experiences-reveal-about-life-and-beyond/ The Division of Perceptual Studies at the University of Virginia: http://med.virginia.edu/perceptual-studies The International Association for Near-Death Studies: http://iands.org BialikBreakdown.comYouTube.com/mayimbialik