Podcasts about Cognitive behavioral therapy

Dr. Donn Posner is a leading expert in Cognitive Behavioral Therapy for Insomnia (CBT-I), founder and president of Sleepwell Consultants, and an adjunct clinical associate professor in the Department of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine. He is co-author of Cognitive Behavioral Therapy for Insomnia: A Session-by-Session Guide, and he has trained and consulted with clinicians nationally and internationally across nearly four decades of clinical practice. In this second of two episodes, the conversation turns from what CBT-I is to how clinicians actually learn and deliver it. Dr. Posner reviews the available training pathways and what proficiency really requires, and explains why sleep hygiene — the advice most patients have already heard many times over — does not treat chronic insomnia, even though it has a place later in the work. He identifies the high-yield principles any clinician can apply immediately, including a fixed morning wake time, early light exposure, and getting out of bed when not sleeping. He then examines sleep effort as a perpetuating factor and CBT-I as fundamentally a therapy of acceptance, describing how he prepares patients for a treatment that will make them feel worse before it makes them better, and how cognitive work addresses the fear and resistance that follow. He closes with what clinicians should expect from a course of treatment — typical length and spacing, responder and remitter outcomes, and the durability of gains — along with how he handles sleep medication and why guidelines place CBT-I ahead of hypnotics.Learning ObjectivesAfter completing this educational activity, participants should be able to:Explain why sleep hygiene is ineffective as a monotherapy for chronic insomnia, and describe the more limited role it plays within a full course of CBT-I.Identify high-yield behavioral sleep medicine principles — including a fixed morning wake time, early light exposure, and getting out of bed when not sleeping — that clinicians can apply before completing formal CBT-I training.Describe sleep effort as a perpetuating factor, and summarize how the cognitive and acceptance-based components of CBT-I address the dysfunctional beliefs and resistance that arise during treatment.Summarize the expected course and outcomes of CBT-I (including typical session number and spacing, responder and remitter outcomes, and durability of gains) and explain why guidelines position CBT-I ahead of hypnotic medication.Topics Covered in This InterviewPathways to training in CBT-I and behavioral sleep medicineBoard certification in behavioral sleep medicineWhy sleep hygiene alone does not treat chronic insomnia: the dental hygiene analogyWhere sleep hygiene does belong within CBT-IAvailable CBT-I training programs and online optionsHow clinicians become proficient: consultation, community, and case experienceHigh-yield behavioral sleep principles any clinician can applySleep regularity, fixed wake times, and morning light exposureWhy getting out of bed is the hardest intervention for patients to acceptSleep effort as a perpetuating factorWhat good sleepers do — and do not do — to fall asleepCBT-I as a therapy of acceptancePreparing patients for the work: “I'm going to make you worse before I make you better”The cognitive component: uncovering and debunking dysfunctional beliefsCommon patterns of resistance, and exposure as the remedyTypical treatment length, session spacing, and pacingResponders versus remitters, and what the outcome data showDurability of gains and the role of sleep self-efficacyManaging and tapering sleep medication alongside CBT-IWhy guidelines position CBT-I ahead of hypnotic medication

If you're doing everything "right" for your sleep and still waking up exhausted, tossing and turning at night, or lying in bed with your brain running a mile a minute, the problem might not be your nighttime routine. It might be what your brain has learned to do when you get into bed. In this episode, I'm sitting down with licensed psychologist Jessica Meers to talk about the psychology of sleep, insomnia, and why some of the things we do to compensate for a bad night of sleep can actually keep the cycle going. Jessica specializes in treating insomnia without medication using Cognitive Behavioral Therapy for Insomnia (CBT-I). She explains why sleep is both biological and psychological, how we can unintentionally train ourselves to associate our beds with stress and wakefulness, and why there is no perfect sleep routine that works for everyone. We also talk about overthinking at night, maintaining a consistent wake time, what to do when you can't fall back asleep, creating a sleep-supportive environment, and how hormonal changes during perimenopause and menopause can affect sleep. If you've been chasing the perfect bedtime routine but still aren't sleeping well, this conversation may help you look at sleep in a completely different way. In This Episode, We Cover: Why sleep affects so much more than how tired you feel the next day The relationship between poor sleep and mental health Why the "5 AM club" approach isn't right for everyone How individual sleep needs can change with age and life circumstances Why sleep is both a biological process and a learned behavior How lying awake, worrying, and tossing and turning can reinforce poor sleep patterns Why overthinkers often struggle when everything finally gets quiet at night Jessica's strategy for scheduling "worry time" before bed Why getting out of bed may be better than staying there trying to force yourself to sleep How to distinguish insomnia symptoms from potential signs of sleep apnea What Cognitive Behavioral Therapy for Insomnia (CBT-I) is Why a consistent wake-up time can be one of the most important parts of improving sleep Why sleeping in to "catch up" after a bad night can disrupt your rhythm How to create a simple wind-down buffer before bed Why temperature and light matter for sleep Why the perfect sleep environment may not be enough when your nervous system is on high alert The relationship between perimenopause, menopause, hormones, and sleep Why addressing sleep may require support from more than one type of practitioner Sleep Is More Than Feeling Tired We tend to think about poor sleep in terms of how we feel the next morning. We're tired. We're foggy. We need more coffee. We don't have the energy we normally have. But Jessica explains that sleep reaches much further than our energy levels. As a psychologist, she pays particular attention to the relationship between sleep and mental health. Poor sleep and insomnia are closely connected with conditions like anxiety and depression, and sleep difficulties can sometimes appear before other mental health symptoms. Sleep also intersects with hormones and metabolic health, which is one of the reasons getting consistent, restorative sleep matters so much for our overall health. This isn't simply about getting enough hours so you can be productive tomorrow. Sleep is one of the foundational systems supporting your physical and emotional health. There Is No Perfect Sleep Schedule One of my favorite parts of this conversation was Jessica's take on the "5 AM club." We see these routines everywhere. Wake up at 5 AM. Work out. Take the cold plunge. Journal. Meditate. Get more done before everyone else wakes up. And while that routine may work beautifully for one person, it doesn't mean it's healthy for everyone. Jessica explains that healthy sleep needs are generally discussed within a range, but the exact amount an individual needs can vary depending on the person, their age, their circumstances, and what is happening in their life. Trying to force yourself into somebody else's sleep schedule can work against what your own body needs. Your goal isn't to become the person who wakes up earliest. Your goal is to find a sleep pattern that actually supports your health. You Can Train Yourself to Sleep Poorly This was such an important distinction. Our bodies know how to sleep. But psychologically, sleep can also become a learned behavior. That means we can unintentionally teach ourselves patterns that make sleeping harder. Think about what happens when you repeatedly lie in bed unable to sleep. You toss. You turn. You start thinking about tomorrow. You worry about how tired you're going to be. You look at the clock. You try harder to fall asleep. And eventually, your brain begins associating your bed with being awake, alert, worried, and frustrated. Instead of your bed becoming a cue for sleep, it becomes a cue for stress. Jessica explains that breaking this association is an important part of addressing insomnia. The goal is to help your brain relearn what your bed is supposed to represent. Sleep. Why Overthinkers Struggle at Night If your brain suddenly decides bedtime is the perfect opportunity to review every problem in your life, you're definitely not alone. During the day, we're distracted. We're working. We're answering messages. We're taking care of our families. We're running businesses. There is always something competing for our attention. Then everything gets quiet. Suddenly, your brain has room to bring up all the things you haven't processed yet. For someone who already tends toward worrying or rumination, bedtime can become the moment when those thoughts get louder. One strategy Jessica recommends is intentionally creating space for those thoughts earlier. Rather than waiting until your head hits the pillow, schedule time after dinner to think through what's worrying you. Write it down. Identify the next step you can take. Give the thought somewhere to go. You're not trying to solve your entire life before bedtime. You're showing your brain that the problem has been acknowledged and there is a plan for dealing with it. What to Do When You Can't Sleep This advice sounds completely backwards at first. If you can't sleep, get out of bed. Jessica explains that staying in bed worrying, stressing, tossing, and turning can reinforce the exact association you're trying to break. You're teaching your brain that bed is where you stay awake and struggle. Instead, get up. Go somewhere else. Do something relatively mindless that you enjoy until you begin feeling sleepy again. Jessica even explains that, in the context of this approach, she would rather someone get out of bed and watch television than stay in bed desperately trying to force sleep while becoming increasingly frustrated. The goal is not to reward yourself for being awake. It's to stop reinforcing the connection between your bed and wakefulness. Could It Be More Than Insomnia? Not every nighttime awakening is caused by insomnia. Jessica also discusses some signs that may warrant talking with a healthcare professional about obstructive sleep apnea. If you're frequently waking during the night and also experiencing symptoms such as loud snoring, gasping for air, morning headaches, or waking with a dry mouth, it may be worth discussing a sleep study with your healthcare provider. This is another reason why getting appropriate support matters. You don't want to spend months trying to "fix" your sleep routine if there is another underlying sleep issue that needs to be evaluated. What Is CBT-I? Jessica specializes in Cognitive Behavioral Therapy for Insomnia, commonly called CBT-I. Rather than relying solely on medication to manage insomnia, CBT-I looks at both the behaviors and thought patterns that may be contributing to sleep difficulties. Jessica describes it as a relatively short-term, structured form of therapy, often completed over approximately six to eight weekly sessions, although treatment needs vary by person. The process can involve changing behaviors around sleep, rebuilding the association between bed and sleeping, addressing worry and rumination, and helping people understand the psychological patterns that may be keeping insomnia going. For someone who feels like they've tried every sleep hygiene tip imaginable without getting lasting results, looking at the behavioral and psychological side of sleep may be the missing piece. Stop Trying to Catch Up on Sleep After a terrible night of sleep, sleeping in feels completely logical. You're exhausted. Your body missed sleep. Why wouldn't you stay in bed longer and catch up? Jessica explains that constantly changing your wake time can disrupt your rhythm and make the next night more difficult. One of the strongest anchors you can give your sleep schedule is consistency in the morning. Rather than obsessing over the exact time you fall asleep, Jessica encourages people to pay attention to when they get up. Set a regular wake time. Get up at approximately the same time each day. And resist constantly shifting your schedule based on how well you slept the night before. One bad night doesn't necessarily need to become several bad nights. Sometimes our attempts to compensate for poor sleep are what keep the pattern going. Give Your Brain Time to Wind Down You cannot expect your brain to go from full-speed work mode to sleep in thirty seconds. If you've been answering emails, working on your business, scrolling on your phone, solving problems, or thinking about tomorrow right up until bedtime, your brain may still be activated when you lie down. Jessica recommends creating at least a short buffer before sleep. Even thirty minutes can give your brain an opportunity to transition. The goal isn't to create an elaborate two-hour nighttime routine filled with ten different wellness practices. It's simply to give yourself a period where you are intentionally disengaging from the activities that keep your brain switched on. Your Sleep Environment Matters, But It Isn't Everything Temperature and light can absolutely support sleep. Jessica recommends keeping your bedroom cool and comfortable, with research often pointing toward temperatures around 67 to 68 degrees Fahrenheit for many sleepers. Darkness can also help. Dimming the lights in the evening gives your body additional environmental cues that nighttime is approaching. But there is an important caveat. You can have the perfect temperature. The perfect blackout curtains. The perfect eye mask. The perfect wind-down routine. And still struggle to sleep if your nervous system is highly activated. If you're lying in bed hypervigilant and on edge, your body's arousal system may be competing with your ability to settle into sleep. Sleep hygiene can support the process. It cannot always solve the underlying problem by itself. Perimenopause, Menopause, and Sleep Jessica's path into sleep psychology actually began through women's health research focused on sleep and the menopausal transition. That made this part of our conversation especially interesting to me. Hormonal changes during perimenopause and menopause can significantly change a woman's experience of sleep. Jessica discusses estrogen's role in sleep and why changes during this stage of life can contribute to sleep disruption. But there can also be a second layer. Once sleep becomes difficult, we naturally start worrying about it. We compensate. We change our routines. We try harder. And some of those psychological and behavioral responses can begin perpetuating the sleep problem even when hormones were part of what triggered it initially. That is why Jessica advocates for a collaborative approach. For some women, that may mean working with a psychologist or sleep specialist alongside a gynecologist, menopause specialist, physician, or other appropriate healthcare practitioner. There isn't always one single solution. You Don't Have to Keep Fighting Your Sleep One of the biggest messages I took from this conversation is that struggling with sleep doesn't mean you simply need more discipline. You don't necessarily need another supplement. You don't necessarily need another complicated nighttime routine. And you definitely don't need to force yourself into somebody else's 5 AM schedule because social media told you that successful people wake up before sunrise. Sometimes the behaviors we use to compensate for poor sleep are actually helping the pattern continue. Understanding those patterns gives you something you can work with. If sleep has become a nightly battle, consider getting support from someone who specializes in sleep rather than continuing to experiment on your own. Your Action Step Pay attention to what happens around your sleep for the next several days. Not just what time you go to bed. Ask yourself: Do I stay in bed worrying when I can't sleep? Do I dramatically change my wake time after a bad night? Am I carrying work and stress directly into bedtime? Am I trying to follow someone else's "perfect" sleep schedule? Do I spend the day worrying about whether I'll sleep tonight? You don't need to change everything at once. Start by noticing the patterns. If those patterns have been going on for a long time or your sleep is significantly affecting your health and daily life, consider speaking with a qualified sleep professional about whether CBT-I or another form of evaluation may be appropriate. Final Thoughts Sleep is foundational. It affects how you think, how you feel, how you show up for your family, and how much energy you have to build the business and life you want. And better sleep isn't necessarily about creating the perfect nighttime routine. Sometimes it starts with understanding what your brain has learned about sleep and changing the behaviors that are keeping you stuck. You can optimize your room. You can buy the eye mask. You can turn down the temperature. But if your nervous system is on high alert and your brain has learned that getting into bed means worrying for three hours, there is another layer that needs attention. That's why I loved this conversation with Jessica. It reminds us to stop chasing perfection and start understanding what our bodies and brains actually need. Resources Connect with Jessica Meers Jessica Meers is a licensed psychologist specializing in insomnia and helping people improve sleep without relying solely on medication. Her practice is based in Houston, Texas, with both in-person and virtual care. Instagram: @SHeTalksSleep Website: rhythm-well.com If you're experiencing persistent sleep problems, consider speaking with a qualified healthcare provider or sleep specialist for individualized evaluation and treatment. _______________________________________________ Visit yourhealthcoachbiz.com to explore done-for-you programs and offers for health coaches. Looking for one-on-one business coaching support? Visit rachelafeldman.com or send me a DM on Instagram at @rachelafeldman.  

Aspirin or biologics? How do you choose the right treatment for AERD? On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash interviews Dr. Andrew White, Director of the AERD Clinic at Scripps Clinic, to discuss the diagnosis and management of this often underrecognized condition. They cover practical strategies for identifying AERD, the importance of a detailed NSAID history, and how treatment decisions are shaped by patient goals and disease severity. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:08 - What Is AERD and Prevalence 06:32 - History Taking and Mechanism 11:10 - Typical Symptom Progression and Alcohol Intolerance 16:41 - When to Do Aspirin Challenge 19:00 - Challenge Protocol And Upper Airway Reactions24:53 - Aspirin Desensitization vs Challenge27:58 - Aspirin therapy after desensitization and Risk of GI Bleeds31:17 - Biologics Change AERD33:42 - Choosing Aspirin Desensitization vs Biologics 35:52 - Patient Counseling and Motivational Interviewing 41:26 - Convenience and Cost of Therapy 44:10 - ENT Allergy Collaboration47:22 - Rapid Fire Pearls51:13 - Future Research & Management Direction54:05 - Final Takeaways --- More about this episode Dr. White explains that AERD affects about 8 to 10 percent of asthmatics, with even higher rates in those with severe asthma or nasal polyps. He reviews typical adult-onset progression, alcohol-related respiratory symptoms, and the underlying pathophysiology, including imbalances in arachidonic acid mediators and leukotriene surges after NSAID exposure.The conversation includes practical questions to ask when taking an NSAID history, such as reactions to common pain relievers or alcohol, and when to consider aspirin challenge. Dr. White also details long-term treatment strategies, including the role of biologics like dupilumab and aspirin therapy after desensitization, with considerations for dosing and gastrointestinal risk. He explains how factors like asthma severity, recurrent polyp disease, sense of smell, cost, and convenience all influence therapy choice. The episode concludes with a discussion of multidisciplinary collaboration, patient counseling, and Dr. White's insights on future research directions in AERD management. --- Resources Aspirin sensitivity and severity of asthma: evidence for irreversible airway obstruction in patients with severe or difficult-to-treat asthmahttps://pubmed.ncbi.nlm.nih.gov/16275362/ Polyphenolic Activation of Basophils Explains Alcohol Hypersensitivity in AERDhttps://pubmed.ncbi.nlm.nih.gov/41065188/ New insights into the mechanisms of aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/39641750/ The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunologyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC7980229/ Safety and outcomes of aspirin desensitization for aspirin-exacerbated respiratory disease: A single-center studyhttps://pubmed.ncbi.nlm.nih.gov/28550988/ Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/17208597/ Factors influencing aspirin therapy after desensitization (ATAD) tolerance in aspirin-exacerbated respiratory disease (AERD) patientshttps://pubmed.ncbi.nlm.nih.gov/41022281/ Feed the Good Wolf: Motivational Interviewing, Cognitive Behavioral Therapy, and Mindsethttps://pubmed.ncbi.nlm.nih.gov/42103433/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

My guest today is Paige Rome, RPsych. Paige is a Registered Psychologist and founder of Common Thread Psychology in Airdrie, Alberta. Paige is trained in Cognitive Behavioral Therapy for Insomnia (CBT-I), the leading evidence-based psychological treatment for chronic insomnia, and brings both professional expertise and personal experience with insomnia to her work. Her broader approach to therapy is collaborative, compassionate, and evidence-based, drawing particularly from Acceptance and Commitment Therapy (ACT), CBT, and trauma-informed and attachment-based approaches.Paige is also the creator of The Better Sleep Blueprint: A 6-Week, Evidence-Based Program for Overcoming Insomnia, a self-guided program designed to help people understand what keeps insomnia going, change their relationship with sleep, and rebuild healthier, more sustainable sleep patterns. Some of the topics we explore include:-How insomnia develops, why it can persist long after the original trigger is gone, and the role of sleep anxiety, hyperfocus, and control.-The paradox of sleep and why trying harder to fall asleep can actually make sleep more difficult.-The core principles of Cognitive Behavioral Therapy for Insomnia (CBT-I) and how it helps retrain patterns that perpetuate insomnia.-How ACT and CBT-I can work together, with CBT-I providing a behavioral roadmap and ACT helping people approach that roadmap with greater acceptance and psychological flexibility.-Practical strategies for better sleep, including consistent wake times, building sleep pressure, understanding your chronotype, and stimulus control.-The role of radical acceptance in insomnia, and how letting go of the struggle to control sleep can help break the cycle that keeps us awake.————————————————————————Paige's website: https://commonthreadpsychology.com/Instagram: https://www.instagram.com/paigerometherapy/The Better Sleep Blueprint:  https://commonthreadpsychology.com/better-sleep-blueprint/————————————————————————Thank you all for checking out the episode! Here are some ways to help support Mentally Flexible:You can help cover some of the costs of running the podcast by donating a cup of coffee! www.buymeacoffee.com/mentallyflexiblePlease subscribe and leave a review on Apple Podcasts. It only takes 30 seconds and plays an important role in being able to get new guests.https://podcasts.apple.com/us/podcast/mentally-flexible/id1539933988Follow the show on Instagram: https://www.instagram.com/tomparkestherapyCheck out my song “Glimpse at Truth” that you hear in the intro/outro of every episode: https://tomparkes.bandcamp.com/track/glimpse-at-truthCheck out my new album, Holding Space! https://open.spotify.com/album/0iOcjZQhmAhYtjjq3CTpwQ?si=nemiLnELTsGGExjfy8B6iw

Returning guest Jess Wright returns to talk about his new book "Dance In A Madhouse," a about a young doctor in the early 1900s committed to an asylum, and engrossed in a murder mystery.  Dr Wright is a renowned expert in psychiatry, and is the author of award winning books on Cognitive Behavioral Therapy. He is also a Novelist, applying his background in medicine & psychology into fiction. This is his second novel. Follow Jess' work and upcoming books at www.jesswrightMD.com Tune in on Monday 8/31 for The Broken Brain's 5th annual live stream for International Overdose Awareness Day! Go to www.dwighthurst.com/live for details.

How Does Therapy Culture Undermine True Healing?   Host Curtis Chang talks with physician and author Matthew Loftus about how therapeutic language can distort ordinary suffering, turn disagreement into "gaslighting," and leave people feeling less capable of changing their lives. They examine the overmedicalization of grief and anxiety, the rise of mental health culture in schools, and why churches risk losing their purpose when pastors start acting like therapists. **This is not an attack on therapy or psychiatric medication. It is a provocative conversation about when mental health care becomes a worldview—and whether our relentless focus on feeling better is actually making us sicker.   02:10 - Therapy Practice vs. Therapy Culture 03:52 - The Importance of Personal Experience 06:34 - The Three Elements of Therapy Culture 10:09 - The Problem with Focusing on Mental Health 13:22 - The Suggestive Power of Diagnosis 15:30 - A Christian Understanding of Suffering 17:57 - Finding Solace in the Midst of Suffering 21:40 - The Role of Medication in Mental Health 25:49 - Knowing When Therapy Becomes Unhelpful 28:30 - The Unique, Healing Functions of the Church  32:21 - How Parents Can Counter Therapy Culture in Schools 35:01 - A Final Word of Encouragement   To give to Good Faith: https://goodfaith.org/donate     Mentioned in This Episode: Matthew Loftus's Resisting Therapy Culture Curtis Chang's Anxiety Opportunity Kathryn Greene-McCreight's Darkness Is My Only Companion What is Cognitive Behavioral Therapy?     Further Reading: DSM5 and the Medicalization of Grief: Two Perspectives (article) Matter over mind: How mental health symptom presentations shape diagnostic outcomes Effectiveness of school-based mental health programs on mental health among adolescents     Scriptures: Romans 8:38–39 (ESV)   More From Matthew Loftus: Matthew's website Matthew's writing at Mere Orthodoxy Matthew's articles at Plough     Follow Us: Good Faith on Instagram Good Faith on X (formerly Twitter) Good Faith on Facebook   The Good Faith Podcast is a production of a 501(c)(3) nonpartisan organization that does not engage in any political campaign activity to support or oppose any candidate for public office. Any views and opinions expressed by any guests on this program are solely those of the individuals and do not necessarily reflect the views or positions of Good Faith.

Why do so many of us struggle with self-doubt, relationship friction, and negative self-talk? In this episode of The Better Life, Dr. Pinkston is joined by Australian family physician and author Dr. Jeremy Thompson to discuss his new book, Understanding Your True Identity: Discover the Real You and Enjoy Healthier Relationships. Together, they dive deep into psychological health, exploring why we acquire negative thought patterns and how to break free from seeing ourselves as a "mixed bag" of flaws and strengths. Dr. Thompson shares actionable strategies from cognitive narrative and solution-based therapies to help you separate your true inner core from life’s baggage, rewire your mindset, and build healthier connections with the people in your world. In this episode, you’ll learn: The root cause of persistent negative inner voices and how to reframe them. How childhood experiences and social media impact our self-identity. Practical strategies to track daily mood triggers and break negative habits. How understanding your core identity leads to deeper empathy and forgiveness in relationships. Connect & Resources Learn more about Dr. Jeremy Thompson: understandyourtrueidentity.com | drjeremythompson.com Visit Dr. Pinkston online: drpbetterlife.com See omnystudio.com/listener for privacy information.

Better sleep isn't just about getting more rest, it's about unlocking a healthier body, a clearer mind, and a deeper connection to your higher self. Eric Bigger and Stanford-trained sleep medicine physician Dr. Feby Maria Puravath Manikat explore how sleep can elevate your consciousness, boost your health, and help you show up as your highest self every day.About Dr. Feby Maria Puravath ManikatDr. Feby Maria Puravath Manikat is a Stanford-trained sleep medicine physician specializing in sleep health, longevity, and integrative medicine. She also trained at Cornell University in nutritional sciences and Harvard Medical School in Cognitive Behavioral Therapy for Insomnia (CBT-I). Blending science with holistic practices, she helps high-performing professionals optimize their sleep to improve health, energy, performance, and overall well-being. Dr. Feby also lectures Stanford's "Sleep and Dreams" course and serves as Sleep Director at Apple's AC Wellness, guiding Apple employees toward better rest, recovery, and peak performance.Website: https://www.febymariamd.com/aboutInstagram: https://www.instagram.com/febypuravath/Check out Miracle Season's collection: https://itsmiracleseason.co/collections/frontpageWork with me: https://www.ericbigger.com/workwithme?utm_source=podcast&utm_medium=podcast&utm_campaign=work_with_m...Connect with Simplified Impact: https://hubs.ly/Q02vvMJ90

Every dad has been there. Your child says something disrespectful. Your spouse reacts in a way you didn't expect. Stress builds at work, and before you know it, you're responding out of emotion instead of wisdom. But what if there was a simple framework that could help you slow down, take ownership of your thoughts, and respond in a way that honors God? In this episode, we're joined by James Lenhoff to unpack the powerful CTFAR method—a practical tool that's helped countless people navigate conflict, parenting, marriage, work, and even financial decisions with greater clarity and self-control. If you've ever wished you could respond more intentionally instead of reacting in the moment, this conversation will give you a framework you'll use for years to come. Links In This Episode Emotion Wheel: https://abrahamswallet.com/wp-content/uploads/2026/07/Emotion-Wheel-1.jpg CTFAR Model Questions: https://abrahamswallet.com/wp-content/uploads/2026/07/Unknown.pdf WealthQuest: https://www.wqcorp.com/ GoodSense: https://goodsensemovement.org/  FreedUp App: https://getfreedup.com/  Please partner with us in inspiring and equipping multi-gen families at https://abrahamswallet.com/support AW website Apple Podcasts Spotify YouTube Facebook LinkedIn Instagram Chapters (00:00:00) - How to Get Through a Conflict With Yourself(00:00:46) - Take Control of Your Wallet(00:01:44) - A Christian Financial Planner on Abraham's Wallet(00:03:36) - Cognitive Behavioral Therapy(00:11:16) - How to Get Through a Conflict With My Wife(00:17:14) - The Real Cost of Blaming Your Partner(00:24:46) - Boundaries for Relationships(00:30:45) - How to Talk About Abusive Relationships(00:33:47) - The Woe and the Money(00:41:12) - The Problem of Spending Too Much(00:45:07) - How to Get Through Anger Issues in Guys(00:48:27) - Share the Emotion Wheel With Others(00:51:56) - C2 is a hard verb(00:52:14) - Good Sense: What's Going On There?

The Brain–Body Connection, Gut Health, Stress, and Medical Gaslighting: board-certified psychiatrist Dr. Susan Trachman, author of “It's Not Just In Your Head,” about psychosomatic medicine and the two-way brain–body connection. Trachman explains how patients with complex symptoms are often dismissed as having “medically unexplained symptoms” and discusses medical gaslighting, especially affecting women and people of color, with examples of missed diagnoses. She describes how inflammation, the gut microbiome, leaky gut, diet, probiotics, fermented foods, and even fecal transplants can influence mood and health, and reviews vagus nerve stimulation research. The conversation covers stress effects, including Takotsubo “broken heart” cardiomyopathy, CBT for anxiety, IBS, and pain, the role of sleep and the brain's glymphatic system, pandemic-related mental health and long COVID symptoms, concerns about GLP-1 drugs causing emotional flatness, and careful SSRI tapering to avoid withdrawal. 

Send us Fan MailHabits can be the key to or the lock on our success.Nearly everything we want to improve, from our health and confidence to our relationships, performance, and wellbeing, depends on what we do consistently. Yet in a world where life already feels relentlessly additive, habit creation can quickly become another overwhelming project.Add a morning routine. Add exercise. Add meditation. Add meal preparation. Add journaling. Add recovery. Add another app that promises to reorganize your entire life by Thursday.In this episode, I strip habit creation back to one simple and practical tool: scaling.Drawing from Cognitive Behavioral Therapy, Motivational Interviewing, and evidence-based coaching, we explore three questions that can help you design habits you're far more likely to sustain:How important is this behavior?How much will I enjoy it?How confident am I that I'll follow through?You'll learn why some habits collapse before they've truly begun, how to make difficult behaviors more personally rewarding, and why reducing the size of a commitment can strengthen rather than weaken your chances of success.This episode isn't about adding more pressure, complexity, or unrealistic expectations to your life. It's about creating greater clarity, building evidence that you can trust yourself, and making meaningful change feel more accessible.Sometimes you don't need a bigger goal or more motivation.Sometimes you simply need to ask better questions before you begin.Visit us at:www.theselfhelpantidote.com

Summary Dr. Lee Warren shares insights on how neuroscience, faith, and personal experience intertwine to help us understand and rewire our brains for healing and growth. Discover practical strategies like self-brain surgery and the role of neuroplasticity in overcoming trauma and grief. Guest Links https://wleewarrenmd.com/ Instagram: https://www.instagram.com/drleewarren/ Youtube: https://www.youtube.com/@drleewarren The Life-Changing Art of Self-Brain Surgery book Chapters 00:00 Introduction to Neuroscience and Personal Journey 04:10 Understanding the Brain's Truth and Lies 07:03 Mind, Brain, and Body Connection 12:51 Self-Brain Surgery: Taking Control of Your Thoughts 21:26 Cognitive Behavioral Therapy vs. Self-Brain Surgery 25:19 The Body Keeps the Score: Trauma and Memory 31:01 Understanding Neuroplastic Pain 33:53 The Journey of Healing from Trauma 40:39 Navigating Grief and Finding Purpose 48:05 Pain vs. Suffering: A Complex Relationship 54:00 The Intersection of Science and Scripture     To contribute to the the Post-Traumatic Growth of Veterans click here. To learn more about Mission 22's impact and programs, visit www.mission22.org or find us on social media. IG: @mission_22. Tiktok: @_mission22

Main content starts at 20:00.Tourette's Syndrome is one of those conditions that has gained increased attention over the past few years. Thanks to the great work of campaigners and individuals wanting to raise awareness and ensure that people understand what the condition actually is, compared to the myths and misconceptions. I've been meaning to develop my own understanding of the condition for a few years, but I hadn't got round to it like a lot of people. Yet when John Davidson, the Tourette's campaigner said something awful because of his Tourette's at the 2026 Oscars, this cemented my determination to learn about Tourette's. Therefore, in this clinical psychology podcast episode, you'll learn what is Tourette's Syndrome, what are the symptoms, how it's treated and more. If you enjoy learning about mental health conditions, neurological differences and psychological treatments, then this will be a great episode for you.In the psychology news section, you'll learn how overreliance on AI leaves students distressed, the hidden trauma of house clearances, and why do we owe ourselves?LISTEN NOW!If you want to support the podcast, please check out:FREE AND EXCLUSIVE 8 PSYCHOLOGY BOOK BOXSET- https://www.subscribepage.io/psychologyboxsetCBT For Anxiety: A Clinical Psychology Introduction to Cognitive Behavioral Therapy for Anxiety- https://www.connorwhiteley.net/cbt-for-anxiety Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and libraries systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca. Patreon- patreon.com/ThePsychologyWorldPodcast#tourettesyndrome #tourettessyndrome #tourettes #tourettesawareness #clinicalpsychology #mentalhealth #clinicalmentalhealth #clinicalpsychologist #mentalhealthawareness #mentalhealthsupport #mentalhealthadvocate #psychology #psychology_facts #psychologyfacts #psychologyfact #psychologystudent #psychologystudents #podcast #podcasts

In this Huberman Lab Essentials episode, I explain the biology, symptoms and types of bipolar disorder (sometimes called bipolar depression), a condition characterized by extreme, maladaptive shifts in energy, mood and perception. I describe the diagnostic criteria that distinguish bipolar I from bipolar II, including mania and hypomania and the different patterns of mood cycling. I discuss the remarkable history and discovery of lithium and how it works, in part by reducing inflammation, providing neuroprotection and supporting the interoceptive neural circuits affected in bipolar disorder. I also cover talk therapies, electroconvulsive therapy and nutraceuticals such as omega-3 fatty acids and inositol, and I explore the intriguing relationship between mood disorders and creativity. This episode should interest anyone who has or knows someone with bipolar disorder, as well as those interested in how the brain balances mood, energy and focus. Read the show notes at hubermanlab.com. Thank you to our sponsors AG1: https://drinkag1.com/huberman BetterHelp: https://betterhelp.com/huberman Eight Sleep: https://eightsleep.com/huberman Timestamps (00:00:00) Bipolar Disorder (00:01:09) Bipolar I; Manic Episode Symptoms (00:05:00) Bipolar II, Hypomania; Depressive Episodes & Cycling (00:09:00) Sponsor: BetterHelp (00:10:09) Lithium Discovery, Dr. John Cade, Uric Acid (00:12:14) Lithium Urate & Guinea Pigs, Control Experiments (00:13:19) Lithium Salts Paper, Toxicity & Monitoring (00:15:40) How Lithium Works: Inflammation & Neuroprotection (00:16:50) Exteroception vs. Interoception, Neural Circuit Atrophy (00:19:04) Sponsor: AG1 (00:20:29) Drug vs. Talk Therapies (00:20:40) Cognitive Behavioral Therapy, Interpersonal & Social Rhythm Therapy (00:22:30) Electroconvulsive Therapy (ECT), Treatment-Resistant Depression (00:24:07) Caution: Rely on Prescribed Treatment, Suicide Risk (00:24:59) Tool: Lifestyle Support, Sleep, Exercise, Nutrition & Sunlight (00:26:05) Tool: Inositol & Omega-3 Fatty Acids, Fish Oil Study (00:29:53) Sponsor: Eight Sleep (00:31:10) Creativity & Mood Disorders, Eminent Individuals Study (00:34:00) Recap & Key Takeaways Disclaimer & Disclosures Learn more about your ad choices. Visit megaphone.fm/adchoices

Short Bio: Thais Gibson is a counselor, speaker, and leader in the personal development field. She has a Ph.D. and is certified in 13 modalities, including Cognitive Behavioral Therapy, NLP, Somatic Processing, and Trauma Work. Her scientific research, personal experience, and compassionate approach led to her founding the Gibson Integrated Attachment Theory™. Through her academic training and client-based research, Thais has created renowned and inspiring courses for personal development, growth, and relationships. These teachings have been distilled into the in-depth programs, courses, and modules inside of The Personal Development School. Links: Instagram, YouTube, Personal Development School, and The Thais Gibson Podcast

What if the biggest obstacle to better health isn't your diet and instead it's the relationship you've built with your body?In this conversation, I sit down with psychologist Dr. Rachel Goldman to unpack why so many women struggle with body image, emotional eating, food noise, and self-worth, especially during midlife.We explore why lasting health isn't built through shame or punishment. It's built through curiosity, compassion, and learning to work with your body instead of constantly fighting against it.We also discuss the psychology behind food noise, body neutrality, GLP-1 medications, menopause, emotional eating, and why your relationship with yourself influences every health decision you make.If you've ever felt like your body has betrayed you, this episode offers a different perspective.In this episode, you'll learn:Why body image goes far beyond what you see in the mirrorThe difference between body positivity and body neutralityWhy food noise develops and how to begin quieting it naturallyHow emotional eating becomes a learned coping strategyWhy your self-worth should never depend on the number on the scaleHow menopause changes the emotional relationship women have with their bodiesWhy slowing down at meals changes more than digestionResources MentionedWhen Life HappensThe Body Keeps the ScoreCognitive Behavioral Therapy (CBT)The Reset AcademyNervous System Reset GuideMore on Dr. Rachel GoldmanDr. Rachel Goldman is a licensed psychologist, clinical assistant professor, media health expert, and nationally recognized speaker specializing in health behavior change, obesity, eating behaviors, stress management, and cognitive behavioral therapy. She is the author of When Life Happens, a practical guide for navigating life's challenges with evidence-based psychological tools.Website: https://drrachelnyc.com Instagram: @drrachelnycWhen Life Happens by Dr. Rachel GoldmanFor more resources related to today's episode, visit the podcast episode page: https://www.drmindypelz.com/ep349/  Connect with Dr. Mindy:Join Reset AcademyWatch the episodes on YouTubeFollow Dr. Mindy on InstagramSubscribe to Dr. Mindy's newsletter for tools and research on fasting, hormones, and metabolic healthDisclaimer: This podcast is intended for educational and informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare professional before making changes to your diet, fasting routine, or lifestyle.

Insomnia and depression are two serious and debilitating conditions. Insomnia on its own is linked to an increase in suicide risk, and insomnia can also exacerbate the severity of depression.Andrea Goldstein-Piekarski, assistant professor in the department of psychiatry and behavioral sciences at Stanford, and Adam Krause, post-doctoral research fellow in Stanford's psychiatry department, are two of the authors of a recent study in the journal Neuropsychopharmacology. Cognitive behavioral therapy for insomnia, or CBTI, is the gold standard for treating insomnia, and it's been shown to relieve depressive symptoms as well.Read the full study here: https://www.nature.com/articles/s41386-026-02431-0 Hosted on Acast. See acast.com/privacy for more information.

In this episode, hosts Drs. Jenna Ermold and Carin Lefkowitz sit down with clinical psychologist and national pain management expert Dr. Jennifer Murphy to dismantle the traditional, "find it, fix it" biomedical approach to chronic pain. Drawing from her extensive background, including five years as the National Director of Pain Management for the VA, Dr. Murphy highlights why addressing persistent pain is a critical piece of mental health advocacy, particularly for Veterans.The conversation explores the complex intersections of chronic pain with PTSD, sleep disturbances, and elevated suicide risk. While providers often feel ill-equipped to ask about pain, Dr. Murphy demystifies the treatment process, revealing that evidence-based protocols (like CBT for Chronic Pain) rely heavily on foundational behavioral health skills clinicians already possess.Because military-connected clients can often be more comfortable entering care to address physical versus behavioral health symptoms, treating a patient's pain can act as a pivotal therapeutic gateway to addressing trauma and PTSD down the road. Ultimately, validating a patient's lived experience is the first step toward restoring autonomy and opening the door to deeper clinical healing. There is no wrong door and the most important thing we can do as providers is keep as many of them open as possible.Did this episode spark your interest in expanding your chronic pain practice toolkit? Did it bring up a question or underscore an impactful moment you experienced? Reach out to us via email or leave us a message on Speakpipe. And remember to stay curious and mind your EBPs!Dr. Jennifer Murphy is a clinical psychologist who has specialized in pain management for twenty years. She is CEO of Pain Expert Consulting and Senior Clinical Strategist for Applied VR. From 2020-2025, Dr. Murphy served as the National Director of Pain Management for the Department of Veterans Affairs. She is lead author of the VA's Cognitive Behavioral Therapy for Chronic Pain Manual, a book entitled Chronic Pain and Opioid Management: Strategies for Integrated Treatment, as well as numerous peer-reviewed publications.Resources mentioned in this episode:AppliedVR: Explore immersive, FDA-authorized virtual reality healthcare technology designed to help patients manage chronic pain. Learn more at AppliedVR.Consortium for Defense Psychology (CDP) Training: CDP offers evidence-based protocol training in CBT for Chronic Pain (CBT-CP) multiple times a year. Check out the upcoming training schedule on our upcoming trainings page Calls-to-action: Take a CBT for Chronic Pain (CBT-CP) workshop through CDPShare your impactful moment in the comments or via https://www.speakpipe.com/cdpp4pSubscribe to the Practical for Your Practice PodcastSubscribe to The Center for Deployment Psychology Monthly Email

In this episode, we're talking about one of the biggest challenges facing students today: mental health during the college years. Between academic pressure, anxiety about the future, loneliness, relationships, social media, and the constant pressure to succeed, many students are struggling quietly and wondering how to navigate it all faithfully and wisely. My guest is Brooke Wesley, a licensed clinical social worker, Certified Eating Disorders Specialist, and co-founder of Bellatore Recovery in the Kansas City area, where she has spent more than two decades helping teens and adults pursue healing and emotional health. Brooke's passion for this work is deeply personal, growing out of her own recovery journey from an eating disorder. Along the way, she has worked in hospitals, schools, recovery programs, and private practice, and she also helped launch Kansas City's first transitional living program for women recovering from eating disorders. She's also the author of Hungry To Be Whole: A Therapist's Story of Healing from Anorexia, where she shares both her personal story and professional insights into recovery and hope. In this podcast we discuss: How overcoming her own eating disorder led Brooke to want to help others. Factors that contribute to students' mental health challenges. Signs of good mental health, and how this relates to success in college (and life). Why students can still be lonely while around so many people, and what to do about it. Signs of unhealthy relational dynamics. How a biblical worldview should help frame our understanding of mental health. Correcting common misunderstandings about mental health. How to recognize when it is time to find a mental health professional. How to find a good mental health professional by asking the right questions. The value of Cognitive Behavioral Therapy. The distinction between anxiety and stress. Specific advice for how parents, grandparents, aunts, uncles, and friends can help a student who may be struggling: signs to watch for and how to be helpful. How churches can help students who are struggling. Examples of those who have experienced healing and wholeness as a result of this journey. Proper and improper ways to use AI. Resources mentioned during our conversation: Brooke Wesley and Maureen Rank, Hungry To Be Whole: A Therapist's Story of Healing from Anorexia College Faith podcast conversations about finding Christian community on campus Aundi Kolber, Try Softer: A Fresh Approach to Move Us out of Anxiety, Stress, and Survival Mode–and into a Life of Connection and Joy

Editor's Summary by Linda Brubaker, MD and Christopher C. Muth, MD, Deputy Editors of JAMA, the Journal of the American Medical Association, for articles published from June 20-26, 2026.

Feeling safe in a relationship isn't just about talking things through—it's about what happens deep within our bodies. When emotional wounds strike or betrayals occur, the impact is felt not only in the heart but in the nervous system, shifting how we experience and respond to our partners. Real healing goes beyond surface-level dialogue and requires us to understand how our physiological state shapes our sense of security, trust, and connection. In this episode, listeners are guided to rethink emotional safety as a whole-body experience. By unpacking the link between the nervous system and relationship repair, the discussion provides science-backed insights and actionable strategies to rebuild trust and connection after relational harm. Whether you're seeking healing after a rupture or tools for ongoing growth, this episode offers a fresh, embodied perspective on what it takes to create lasting emotional safety. Dr. Monique Thompson is a trauma-informed therapist, life coach, and best-selling author with over two decades of clinical experience. Her work integrates Eye Movement Desensitization and Reprocessing (EMDR), Brainspotting, Internal Family Systems (IFS), Polyvagal-informed care, and principles of epigenetics to help individuals and couples heal trauma, rebuild trust, and create lasting emotional regulation and resilience.   Episode Highlights 03:56 Reflecting on healing through a car wreck metaphor. 09:09 Exploring Jill Bo Taylor's groundbreaking insights. 15:37 Exploring modern infidelity in relationships. 17:57 Exploring complex relationship dynamics and boundaries. 20:25 Addressing hidden relationship issues. 24:38 Exploring the hidden mental health benefits of walking. 28:35 Exploring color connections to mood during walks. 31:51 Reflecting on and expressing gratitude with loved ones. 36:12 Decoding therapy lingo and referral insights. 39:36 Navigating decisions with trauma awareness. 43:34 Navigating healing after childhood trauma. 48:58 Exploring stress and its hidden effects. 50:29 Exploring the concept of emotional hygiene. 53:32 Discovering unexpected insights from partners who cheated. 57:04 Exploring relationship growth resources.   Your Checklist of Actions to Take Pause and Breathe: Take a moment of pause with deep breaths to settle yourself and become present before addressing relationship issues. Self-Inquiry: Regularly check in with your deeper feelings and truths, beyond your immediate surface reactions, to get clarity on your emotional state. Take Ownership: If you've contributed to a rupture, take personal responsibility and reflect on the most obvious way you can begin repair, such as ending harmful behaviors. Prioritize Emotional Check-ins: After a rupture or betrayal, consistently check in emotionally with both yourself and your partner to stay aware of what you both need. Spend Time in Nature: Set aside at least 11 minutes outside, either walking or sitting, to help lower stress levels and support nervous system regulation. Engage in Movement: Use mindful walks of 30-45 minutes to process emotions and shift your physiological state toward calm and self-connection. Invite Supportive Companions: Bring to mind or reach out to someone who has supported you in the past, letting their positive influence help regulate your emotions. Seek Professional Guidance: If trauma or recurring ruptures persist, consult a trauma-informed therapist or coach, asking for specific referrals rather than relying on generic online searches.   Mentioned Infidelity Recovery Workbook for Couples (*Amazon Affiliate link) (book) My stroke of insight (TED) (video) Helen Fisher (website) Polyvagal Theory (website) Gottman Institute (website) Cognitive Behavioral Therapy for Depression 12 Relationship Principles to Strengthen Your Love (free guide)   Connect with Dr. Monique Thompson Website: doctormoniquethompson.com Facebook: facebook.com/MoniqueThompsonLPC YouTube: youtube.com/@mthompsonlpc Instagram: instagram.com/drmoniquethompson LinkedIn: linkedin.com/in/dr-monique-thompson-dha-lpc-lpc-s-a3066041  

Show notes: (0:00) Intro (0:33) Meet Dr. Nicholas Fabiano and his work in lifestyle psychiatry (4:41) Exercise, depression, prevention, and treatment (9:50) How to "prescribe" exercise using the FITT principle (15:38) Nutrition, ultra-processed foods, and mental health (17:46) Microplastics, processed foods, and exposure risks (23:58) Creatine for depression, cognition, and brain energy (28:21) Creatine, sleep loss, and cognitive performance (35:42) Sleep hygiene tips that support better rest (38:56) How CBT helps change thoughts, behaviors, and mood (43:18) CBT vs. longer-term talk therapy (45:53) Where to follow Dr. Nicholas Fabiano (46:35) Outro   Who is Dr. Nicholas Fabiano?   Dr. Nicholas Fabiano is a psychiatry resident and researcher at the University of Ottawa Department of Psychiatry. His work focuses on the connection between physical and mental health, with special interest in lifestyle psychiatry, exercise, nutrition, sleep, and supplements like creatine. He studies how these tools may support the treatment and prevention of mental health conditions, especially depression. Dr. Fabiano brings both research knowledge and a practical, patient-centered view to mental health care, helping people understand that small daily habits can play a meaningful role in how they feel, think, and function. Connect with Dr. Nicholas:   Website: https://www.nicholasfabiano.ca/ LinkedIn: https://www.linkedin.com/in/ntfabiano/ X: https://x.com/NTFabiano IG: https://www.instagram.com/ntfabiano/ Links and Resources: Peak Performance Life  Peak Performance on Facebook Peak Performance on Instagram

Jonathan Dickinson sat on the floor of a temple in Gabon, initiated into the Bwiti tradition. He built the only ethical supply line out of that forest when no one else would. He co-authored the safety guidelines the entire field depends on, was part of the landmark Stanford research, and runs one of the world's leading ibogaine clinics through Ambio Life Sciences. This year he poured fifteen years of it into a new book.Psychedelics have moved from the counterculture to the President's desk, and our most elite warfighters are quietly leaving the country to get a treatment America still calls a crime. At the center of it is a root the people of Gabon have called a teacher for thousands of years.Jonathan walks us through what ibogaine appears to do for trauma, addiction, and brain injury, where the science is astonishing, and where the honest answer is still that we don't know. He describes a door this medicine opens in the mind, one he says the modern world has trained us to keep shut.Jonathan Dickinson WebsiteAmbio Life Sciences

You can't control your feelings, but you can influence them by choosing your next thought and action. In this episode, host Peter Fenger sits down with Anthony Verdino, a Licensed Clinical Social Worker and author of the new book, “CBT Simplified: A Simple Guide to Understanding Cognitive Behavioral Therapy”. Drawing from his extensive background in outpatient hospital settings and private practice, Anthony specializes in using Cognitive Behavioral Therapy to help clients of all ages build mental resilience and emotional stability. Together, Peter and Anthony demystify mental health by breaking down complex concepts into a practical, accessible toolkit. From breaking the cycle of procrastination and mastering assertive communication to reframing negative thoughts, this conversation offers compassionate strategies to help you regain agency, lean into your challenges, and build lasting resilience.   For more information about “CBT Simplified: A Simple Guide to Understanding Cognitive Behavioral Therapy” by Anything Verdino, LCSW, please visit: https://www.amazon.com/dp/B0FHG24D7M For more information about Anthony Verdino, LCSW, please visit: https://www.anthonyverdino.com Connect with Anthony on Linkedin at: https://www.linkedin.com/in/anthony-verdino-lcsw-87a6806b

Many of you may have heard me talk about the impact of brain development on behavior in different life stages (if not, check out my TEDX Talk - link below).  Well, dopamine is in all of us - do you know it is intricately connected with "rewards"?  And CBT is intricately connected to dopamine.Are we seeing a symbiotic relationship?  Check out this episode where we get the dope on dopamine.Be sure to sign up to our email list on the website, and check out the new program structure and pricing options.My TEDX Talk is live!  Beyond Dog Training: The Movement Toward Sentiencehttps://youtu.be/avUugazybwcFind all the episodes on Feedspot, where Dog Training DisrUPted is rated in the top 5 shows in the dog category in Canada:  https://blog.feedspot.com/canadian_dog_podcasts/To become a certified Canine CBT Psychotherapist, and for courses on related topics, please visit the Institute of Canine Psychotherapy. www.instituteofcaninepsychotherapy.comBecome a Certified Canine Behaviorist and Dog TrainerMy Linktree with all my media, presentations, shows, articlesBillie Groom - UPWARD Dogology | Instagram, Facebook | LinktreeHere is the link to the recent article in Psychology Today Mag by Marc Bekoff on Canine CBTDog Training: Perception, Cognition, and Emotions | Psychology TodayBuy My Book! Winner of the 2019 American Best Book Fest Award (pets/narrative/non-fiction)The Art of Urban People With Adopted and Rescued Dogs Methodology: Rescued Dogs: The Misunderstood Breed: Groom, Billie: 9781525547287: Books - Amazon.ca

Click to Text Thoughts on Today's EpisodeDoes your sleep tracker know you better than you know yourself — or is it just stressing you out? If you've ever woken up more anxious about your sleep score than actually rested, this episode is for you. We're cutting through the noise, the supplements, and the sleep-maxing culture to get back to what actually works — a common-sense, no-fuss approach to sleeping better in midlife. Because you're not broken. You're just navigating a body that's changing, and there's a lot you can do about it.In this episode we cover:Why your sleep target might not actually be 8 hours — and what the research really saysMorning light exposure and why it's one of the most powerful (and free) sleep tools availableThe concept of "orthosomnia" — sleep anxiety caused by your wearable data — and when to just take it offHow the narrative in your head affects your sleep (and a simple CBT-I reframe to try tonight)Caffeine's half-life and why that afternoon coffee may still be in your system at midnightAlcohol's impact on REM sleep and a simple habit to reduce the damageBlood sugar balance and how overnight crashes could be waking you up at 3 AMMagnesium — what the research supports, which forms to look for, and how to get more through foodBlue light, screens, and practical ways to protect your melatonin production at nightPre-sleep nutrition: why going to bed hungry is just as disruptive as eating a heavy mealHormone therapy as a legitimate sleep tool — and why it's worth a conversation with your doctorBreathing techniques (4-7-8 and box breathing) for falling back asleep in the middle of the nightThe eye movement trick that works for falling back asleepTemperature regulation and the ideal bedroom temp for quality sleepConsistent sleep and wake schedules — and why weekends matter more than you thinkExercise timing and why a late intense workout might be costing you sleepThe truth about melatonin dosing — why less is almost always moreCBT-I as a first-line clinical recommendation and the free app that can help you implement itSource Links1. Seven hours optimal in midlife Cambridge/Fudan University study, Nature Aging (2022): https://www.cam.ac.uk/research/news/seven-hours-of-sleep-is-optimal-in-middle-and-old-age-say-researchersAASM/Sleep Research Society joint consensus (seven or more hours): https://aasm.org/seven-or-more-hours-of-sleep-per-night-a-health-necessity-for-adults/2. Morning light / suprachiasmatic nucleus Frontiers in Neural Circuits (2024) — SCN as master circadian pacemaker: https://www.frontiersin.org/journals/neural-circuits/articles/10.3389/fncir.2024.1385908/full3. Magnesium L-threonate for sleep 2024 randomized controlled trial, Sleep Medicine X (ScienceDirect): https://www.sciencedirect.com/science/article/pii/S25901427240001934. Melatonin dosing Sleep Foundation — melatonin dosage guide (reviewed by board-certified sleep physician): https://www.sleepfoundation.org/melatonin/melatonin-dosage-how-much-should-you-takeMelatonin content variability in supplements (the 83–478% finding): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10053496/5. CBT-i as first-line treatment American College of Physicians recommendation: https://www.acponline.org/acp-newsroom/acp-recommends-cognitive-behavioral-therapy-as-initial-treatment-for-chronic-insomnia6. The Atlantic article "American Insomnia" by Jennifer Senior, The Atlantic, August 2025: https://www.theatlantic.com — search "American Insomnia Jennifer Senior" (may be behind paywall; Apple News+ has audio version)My latest recommended ways to nourish and move your body, mind and spirit: Nourished Notes Bi-Weekly Newsletter30+ Non-Gym Ways to Improve Your Health (free download)Connect with Amy: GracedHealth.com Instagram: @GracedHealthYouTube: @AmyConnell

Thais Gibson is a counselor, speaker, and leader in the personal development field. She has a Ph.D. and is certified in 13 modalities, including Cognitive Behavioral Therapy, NLP, Somatic Processing, and Trauma Work. Her scientific research, personal experience, and compassionate approach led to her founding the Gibson Integrated Attachment Theory™. Through her academic training and client-based research, Thais has created renowned and inspiring courses for personal development, growth, and relationships. These teachings have been distilled into the in-depth programs, courses, and modules inside of The Personal Development School.  Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Send us Fan MailS6 E132 - Can't Sleep? Try This Meditation for Insomnia & Racing ThoughtsCan't sleep? If you're lying awake at night with racing thoughts, sleep anxiety, frustration, or middle-of-the-night wake-ups, this guided meditation for insomnia is designed to help you stop fighting sleep and relate to wakefulness with more calm, mindfulness, and self-compassion.In this episode of Sleep Takeout, clinical psychologist Dr. Daniel Baughn guides you through a gentle Leaves on a Stream meditation adapted specifically for insomnia, nighttime anxiety, and difficulty falling back asleep. Rather than trying to force sleep, empty your mind, or “make yourself relax,” this practice helps you notice sleep-related thoughts, feelings, and body sensations without judgment — and then gently return your attention to the image of leaves floating down a stream.This meditation may be especially helpful if you struggle with:Difficulty falling asleepWaking up in the middle of the nightEarly morning awakeningsRacing thoughts at bedtimeSleep anxietyFear of not sleepingFrustration about being awakeChecking the clockWorrying about tomorrowFeeling tense, restless, or alert in bedInsomnia-related body sensationsOverthinking at nightTrying too hard to sleepThis practice is rooted in mindfulness, self-compassion, anxiety treatment, and principles often used alongside Cognitive Behavioral Therapy for Insomnia, also known as CBT-I. The goal is not to force sleep to happen. The goal is to soften the struggle with wakefulness, notice thoughts and sensations more gently, and give your mind something steady and compassionate to return to. If you are awake at 2 AM, 3 AM, or 4 AM wondering, “Why can't I sleep?” or “How do I calm my racing thoughts at night?” this episode can help you practice a different response: noticing, allowing, and returning. Use this guided sleep meditation when you are lying in bed, during a nighttime awakening, before sleep, or anytime you want to practice letting go of anxious thoughts about sleep.In this episode, you'll practice:Mindfulness for insomniaA Leaves on a Stream meditationLetting go of racing thoughtsNoticing sleep anxiety without judgmentResponding kindly to nighttime wakefulnessBecoming aware of body sensations without fighting themReturning attention gently when the mind wandersReducing the struggle around being awakeThis episode is not about perfect sleep. It is about building a calmer, more compassionate relationship with your mind and body when sleep feels difficult.00:00 Welcome and Setup01:19 Visualize the Stream02:13 Place Thoughts on Leaves03:30 Handle Feelings and Sensations05:52 Let Go of Control07:20 When the Mind Hooks You08:55 Kindness in the Night09:46 Nonjudgmental Awareness11:54 Closing Rest and Return✨ Real rest isn't just about falling asleep, it's about feeling at ease again. I'm Dr. Daniel Baughn, sleep psychologist and co-host of Sleep Takeout. I help professionals and high-achievers who seem to have everything together on the outside but can't quite turn off their minds at night. Sometimes, a simple conversation can be the start of real change.

Dr. Marty Makary out as FDA Commissioner—was he the victim of a BigPharma purge? Are “liquid biopsies” useful for predicting recurrences, as well as guiding therapy, for cancer? Nighttime smartphone by adolescents surges, eroding kids' sleep needs; Persistent itch may require an “all of the above” approach to break its vicious cycle—could topical vitamin B12 provide an answer? Study critiques research methods that fast-tracked new Alzheimer's drugs.

Welcome to The Mental Breakdown and Psychreg Podcast! Today, Dr. Berney and Dr. Marshall discuss Cognitive Behavioral Therapy and how it works for ADHD, depression, and many other mental health conditions. Read the article from ADDitude Magazine 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. 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!

Send us Fan MailOkay, hear me out before you accuse me of trying to turn into your grandmother's motivational fridge magnet.This episode is not about pretending everything is amazing while your life is on fire. I'm not asking you to slap on a fake smile, repeat “I am a wealth magnet” seventeen times, and spiritually bypass your way through reality. In fact, I talk about why that kind of toxic positivity can actually make you feel worse.But dude… I also think a lot of us have swung way too far in the other direction.We are marinating in negativity right now. Doom scrolling. Catastrophizing. Convincing ourselves that menopause is an apocalypse, the world is collapsing, and one missed workout means we're physically declining in real time. And honestly? I think we need to positive the f*ck up a little.In this episode, I unpack the difference between old-school affirmation culture and evidence-based mindset work like CBT. We talk about why all-or-nothing thinking keeps people stuck in fitness, weight loss, and life in general. I share stories from clients who think they're either “being good” or completely blowing it, and why that mindset backfires every single time.I also go on a bit of a rant about menopause marketing because apparently women in their 30s are now being called “peri-preppers,” which honestly makes me want to launch myself into the sea.Mostly, this episode is about choosing a more balanced reality. Not fake positivity. Not denial. Just refusing to feed your brain a constant diet of helplessness and doom.Because yes, hard things exist. Negative emotions are part of being human. But so are hope, progress, resilience, strength, joy, and possibility.And if the quality of your life is the quality of the emotions you feel most often… then maybe it's worth asking yourself what emotional climate you're living in every day.What's Inside:Why toxic positivity and toxic negativity are both trapsThe difference between affirmations and evidence-based mindset shiftsHow all-or-nothing thinking sabotages fitness and weight lossMy honest thoughts on menopause marketing and identity-based thinkingLook, I'm not saying you need to fake positivity or pretend life isn't hard.I'm saying your brain is constantly collecting evidence for whatever story you feed it most often. And a lot of us are feeding ourselves a nonstop stream of doom, decline, and helplessness.You can acknowledge hard things without making them your entire identity.So here's my question for you:Where in your life do you need to positive the f*ck up a little?Let me know on Instagram. Mentioned in This Episode:LolalomusicAlthea CrimminsOonagh Duncan on InstagramFit Feels GoodLeave me a voice note on Speak Pipe!

I told a small, self-deprecating… white lie.To get out of committing to volunteering for a new project.My bad.You see? I had history with this person. Co-founder of an advocacy nonprofit. Small. Neurodivergency-affirming. Big ideas. Little organization.“I'm not sure I'm the right guy for your project. I just can't seem to do something… this big… anymore.” I just want to gracefully bow out. Yet not hurt feelings. Or challenge them.I plough on gamely, “Maybe we can chat once in a while…?”“Sure you can! I know you can do it!” That zeal of a new convert to pop psychology. Rapid-fire words ricocheting out of my headset. “You just have imposter syndrome. I know. Because I do too! I have this book you could read…”I tried to be gentle. “My friend, I don't have a syndrome of any kind. I'm just telling the truth. No need for diagnosis.”It went rapidly downhill from there.Let's say, I felt immediate… unease.While we were talking. But I didn't know why. Yet.But like a persistent smell neurodivergent-dot-me can never ignore… that feeling lingered. Building as I replay the conversation over and over. Then it takes days to recover. Before I can work on my projects again.Because what I experienced? Some label “benevolent ableism.” I call it soft-core discrimination. Trying to look like… kindness.I'll never know their motivation. I won't risk the pain of asking.You see? “Kind” words can do real damage.All you really gotta do to cause pain? Simply speak in the grammar of help… then act out the logic of condescension.That's it.Some research supports this… catch-22. Patronizing support? It's one of the most common, damaging, and invisible acts one human can perpetrate on another disabled human. That I know.Cuz it's deniable. So at best, socially dangerous to challenge. A lot like an unwanted, ambiguous… intimate… gesture. From an acquaintance. And queasiness has only gotten worse for me with every ambiguous human interchange.The weapon and pain metaphors I use in the performance piece? Intentional.Cuz the escalation you may experience?These. Are. My. Reality.This ain't about an additional diagnosis. Or a personality flaw. It is about me being autistic-as-fuck me.Yeah. I may be a tad more sensitive to condescension than the Average Bear. Just like I need sunglasses. Even on many cloudy days.Which ought to be actually advocated for. Not patronized. By an advocate. Or employer. Or loved one.Cuz this is not something I can self-help-guru my way out of. Or be trained to control through Cognitive Behavioral Therapy.Like I need one more thought to exhaustingly monitor. Monitoring that could never “cure” my sensory issue with smells. Or my freaking balance problems. Least of all my condescension trauma…So, the only guiding principle I must remember when I navigate social or professional waters…“I must honor my limits. Or they will disable me.”One last thing…I wrote this about my real experiences as an autistic professional. In a world unkind to difference.But my guess? Folks from any “disadvantaged” background may see themselves in it.Let's build on that kinship. Maybe make a change. Together.IntroContent Note: Contain”IntroContent Note: Contain”IntroContent Note: Contains descriptions of everyday condescension… and opinions. That may resonate uncomfortably for autistic, neurodivergent, and… other people.The Cruelest Knife Leaves No ScarYou never feel the cruelest knife Poison-tipped with a pat on the head A smugly… gentle… smile Words so softly, warmly… said.He only said… “You're flourishing. Even with autism. Good on you.”Judgment is like napalm Dropped benignly… safely… from on high Burning invisibly… under my skin.She casually said… “You got imposter syndrome. I got this book…?”Or some radiant dirty bomb Parachuting slyly… tenderly… Silently melting my guts inside.The manual simply read… “Neurodivergents think outside the box. That makes them perfect… for certain tasks.”Leaving a foul smell in the air Mustard gas masquerading… Like piercing gas-station incense Labelled... blindingly, “Stay Calm.”Stealth Weapons of Mass Humiliation Or casual toxic caring Preening in plain sight Don't breed even sullen gratitude Just resentment. Rebellion. Sometimes? The worship of tyrants. You never feel the cruelest knife No, Not right away. A slice so sharp it leaves no scar So weird… that instant shapes my life.More autistic lived experience: If this resonated for you, I share more pieces like this on AutisticAF Out Loud.Readings for Your Deeper DiveNot exhaustive. Just sources that made me think.Benevolent Ableism* “Consequences of Confronting Patronizing Help for People with Disabilities” Harvard Kennedy School Government and Applied Psychology Lab · January 2023https://gap.hks.harvard.edu/consequences-confronting-patronizing-help-people-disabilities-do-target-gender-and-disability-type* “Misguided Gestures of a Condescending Kindness” Radical Accessible Communities · July 2013https://radicalaccessiblecommunities.wordpress.com/2013/07/10/misguided-gestures-of-a-condescending-kindness/Ableist Microaggressions* “Ableist Hostility Disguised as Friendliness” Real Social Skills · January 2016https://realsocialskills.org/2016/01/08/ableist-hostility-disguised-as-friendliness/* “Ableist-Microaggressions Towards People with Disabilities” REDIS / CEDID · n.d.https://redis.cedid.es/index.php/redis/article/download/1161/568/Discriminatory Gaslighting vs. Imposter Syndrome* “Imposter Syndrome, Or Something Else? Historian Talks Discriminatory Gaslighting” NPR · May 2021https://www.npr.org/2021/05/09/995172973/imposter-syndrome-or-something-else-historian-talks-discriminatory-gaslighting* “Imposter Syndrome in Neurodiversity” The Rowan Well · December 2024https://www.therowanwell.co.uk/blog/imposter-syndrome-in-neurodiversityPerformative Allyship & Movement Co-optation* “Performative Neurodiversity – the Appropriation and Watering Down of a Human Rights Movement for Profit” Therapist Neurodiversity Collective · May 2024https://therapistndc.org/performative-neurodiversity-the-appropriation-and-watering-down-of-a-human-rights-movement-for-profit/* “Performative Allyship Within Capitalist Systems” Neurodiverging · January 2024https://www.neurodiverging.com/performative-allyship-within-capitalist-systems/Autistic Identity, Masking & Ableism (Research)* “Understanding Autistic Identity Contingencies” PubMed Central · December 2025https://pmc.ncbi.nlm.nih.gov/articles/PMC12804416/* “The Division Between Neurodiversity Advocates and The Rest of the World” Neuroclastic · January 2026https://neuroclastic.com/nd-nt/Counterpoint / Complicating Perspectives* “Make Neurodiversity Boring” Boston Review · June 2025https://www.bostonreview.net/forum/the-future-of-neurodiversity/make-neurodiversity-boring/* “The Definitional Problems at the Heart of the Neurodiversity Movement” STAT News · November 2025https://www.statnews.com/2025/11/24/neurodiversity-movement-neurotypical-definitional-problems/Weapon Metaphor & Language (Supporting Context)* “The Metaphor as Weapon” Harvard Political Review · February 2015https://harvardpolitics.com/metaphor-weapon/* “Weaponizing Words: War Metaphors and Public…” UIN Malang e-Journal · June 2025https://ejournal.uin-malang.ac.id/index.php/humbud/article/view/32376Connect:* Drop a comment… How do you experience… condescension?* How have you answered it?* Hit the “subscribe” box for new releasesGet the Chapbook:Press enter or click to view image in full sizeevery clock is a handgun pointed at my head, art, poetry, and raw neurodivergent truth. Thirteen pieces. One autistic life, unfiltered. Available on AmazonSubscribe to AutisticAF Out Loud… free or paid… and get the full PDF in your inbox. On me. #AutisticAF Out Loud Newsletter: One Voice. Raw. Real. Fiercely Autistic.I'm an autistic poet and spoken word performer, diagnosed at 63. Now in my 70s. I've been publishing AutisticAF Out Loud since 2019… work that refuses to be packaged.My spoken word piece , every clock is a handgun pointed at my head, was published in Wordgathering, a journal of disability poetry & literature. In 2022, I spoke at the UN World Autism Acceptance Day about my illustration work rooted in autism & ADHD.I live in a rural Indiana trailer… across the courtyard from my wife's trailer… with my 2 dogs & cat. Occasionally I shave… to face Walmart.The algorithms hate me. I must be doing something right.#SpokenWord #AutismAcceptance #AutisticPoetry#AutisticAF Out Loud Newsletter is a reader-supported publication. Click below to receive new posts… free. To support my ongoing work, consider a paid subscription.Support AutisticAF.me with a one-time tip here: Paypal · Ko-Fi · Facebook Pay “Johnny Knapp Âû”https://ko-fi.com/autisticaf This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit johnnyprofaneknapp.substack.com/subscribe

"I know what I need to do, but I don't trust that I'll do it when I need to do it." If that sentence lands, this conversation is for you. In this episode of Refined Leadership: ADHD Lens, I sit down with Dr. Russell Ramsay, one of the leading voices in adult ADHD and Cognitive Behavioral Therapy. We talk about his new book, Once I Get Started, and the cognitive theme he believes runs beneath much of adult ADHD: self-mistrust. This is not a productivity conversation. It is a conversation about what actually happens between knowing what to do and doing it — and why that gap shows up so often for capable, high-performing professionals. What we explore: Self-mistrust as a possible central cognitive theme of adult ADHD, and how it shapes self-worth, decisions, and follow-through Why ADHD is better understood as a performance problem than a knowledge problem Motivation as an emotion, and why deadline pressure stops being a sustainable strategy Self-regulatory efficacy: why some people disengage early, and what protects against it How thoughts, feelings, and behaviors operate as a braided cord rather than a linear chain People-pleasing, social capital, and why ADHD professionals may overestimate their relational debts Procrastivity, or productive procrastination — when it is adaptive, and when it is avoidance Taskidermy tasks: the items that keep reappearing on your to-do list without moving forward The SAP Method: Specific, Actionable, Pivot Points for getting unstuck How CBT for adult ADHD differs from CBT for depression or anxiety, and why the implementation focus matters Masking, intentional self-presentation, and the difference between coping and concealment This episode offers language for patterns that often go unnamed at work — and a more grounded way to think about why standard advice keeps falling short. About Dr. Russell Ramsay: Dr. Russell Ramsay is a psychologist who specializes in the assessment and psychosocial treatment of adult ADHD. He has lectured internationally, published widely, and authored six books on adult ADHD, including his most recent, Once I Get Started. He is a CHADD Hall of Fame inductee.   Pre-order Once I Get Started by Russell Ramsay, Ph.D.: https://www.penguinrandomhouse.com/books/783710/once-i-get-started-by-russell-ramsay-phd/     Connect with Cathy Rashidian: ReadySetChoose.com Resources: Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist Instructions https://add.org/wp-content/uploads/2015/03/adhd-questionnaire-ASRS111.pdf  

The way it is presented you'd think that Cognitive Behavioral Therapy (CBT) is the only therapy treatment for anxiety, depression and other mental health conditions. No, it isn't. It does work, but not for every person or every mental health condition.   In this episode, a quick review of what CBT is and some of the pros and cons. This isn't an attempt to praise or condemn the therapy. I just want to point out that it might not be right for you at this time or you might needs to get your symptoms in control before you can consider this type of treatment.   Resources Mentioned:  American Psychological Association on Cognitive Behavioral Therapy   Book publisher Wiley has the Cognitive Behavioral Therapy for Dummies book. On the website you can read sample chapters and there is a cheat sheet you can review to see if the book is a good match for you.   MindDoc is an app that is a CBT type education that you can access via your phone. You can read or listen to a variety of topics, monitoring and self-management your mental health and check in on you daily. There is a free and paid version of the app that is available to Android and iOS users.   What's Up app for iPhone/iPad users provides a basic grounding in CBT topics and skills. it has a journaling and notes section, breathing exercises and grounding tools. It is free but there are in-app purchases. Emergency Resources The Trevor Project: Provides crisis support specifically for LGBTQ+ youth through phone (1-866-488-7386), text (START to 678-678), and online chat. Available 24/7. They also provide peer support and community.    Veterans Crisis Line: Call 988 and press 1, text 838255, or chat online. There are phone lines for those serving overseas. Visit the website to find the current status of the Veteran line and international calling options.    National Crisis Text Line: Text HOME to 741741 for free, confidential support 24/7. This service operates independently of the 988 service. Users can use text, chat or WhatsApp as a means of contact.   Disclaimer:  Links to other sites are provided for information purposes only and do not constitute endorsements.  Always seek the advice of a qualified health provider with questions you may have regarding a medical or mental health disorder. This blog and podcast is intended for informational and educational purposes only. Nothing in this program is intended to be a substitute for professional psychological, psychiatric or medical advice, diagnosis, or treatment.  

For decades, an MS diagnosis came with outdated advice and significant uncertainty regarding starting a family. Today, the conversation has shifted from "Is it possible?" to "How do we optimize the journey?" This week, we're taking a deep dive into the essential considerations for family planning, managing MS during pregnancy, and the crucial postpartum period.  We're joined by Dr. Riley Bove, an Associate Professor of Neurology at UCSF and a leading expert in hormonal influences on MS. Dr. Bove brings her extensive research background and clinical expertise to help us understand how to navigate disease-modifying therapies while planning a family, the biological shifts that occur during pregnancy, and how to build a robust support system for the "fourth trimester." We're also sharing study results that provide some optimistic news for people experiencing MS-related depression. We'll tell you about a study that explains the actual changes in the immune system that occur when someone with MS exercises. If you get your health insurance on the Affordable Care Act online marketplace, we'll explain why health economists feel certain that your premiums will be going up again next year. And we're also sharing some sobering research that highlights systemic inequities that prevent people with MS who rely on Medicaid from accessing high-efficacy disease-modifying therapies. We have a lot to talk about! Are you ready for RealTalk MS??! This Week: MS and family planning, pregnancy, and postpartum  :22 STUDY: High-efficacy disease-modifying therapies are not available to all Medicaid recipients   1:08 Millions have failed to renew their ACA individual health insurance plans  5:05 STUDY: Cognitive-behavioral therapy improves MS-related depression  9:32 STUDY: Researchers identify the biological mechanisms that are impacted when people with MS exercise  11:29 Dr. Riley Bove discusses family planning, pregnancy, and postpartum issues that affect women with MS  14:48 Share this episode  35:31 Next week  35:50 SHARE THIS EPISODE OF REALTALK MS Just copy this link & paste it into your text or email: https://realtalkms.com/453 ADD YOUR VOICE TO THE CONVERSATION I've always thought about the RealTalk MS podcast as a conversation. And this is your opportunity to join the conversation by sharing your feedback, questions, and suggestions for topics that we can discuss in future podcast episodes. Please shoot me an email or call the RealTalk MS Listener Hotline and share your thoughts! Email: jon@realtalkms.com Phone: (310) 526-2283 And don't forget to join us in the RealTalk MS Facebook group! LINKS If your podcast app doesn't allow you to click on these links, you'll find them in the show notes at www.RealTalkMS.com STUDY: Access to High-Efficacy Therapies for Multiple Sclerosis Under Medicaid: Variation in Coverage and Utilization Across States https://aan.com/msa/Public/Events/AbstractDetails/61520 STUDY: Effectiveness of Cognitive Behavioral Therapy for Depression in Patients with Multiple Sclerosis: A Systematic Review and Meta-Analysis https://journals.lww.com/md-journal/fulltext/2026/04170/effectivess_of_cognitive_behavioral_therapy_for.27.aspx STUDY: Physical Exercise Modulates T Cell Activity and Mitigates Synaptic Dysfunction in Multiple Sclerosis Through Vagus Nerve Engagement https://sciencedirect.com/science/article/abs/pii/S0889159126002710 UCSF Clinical Trials: Pregnancy Registry, Infants, Serum/Milk Analysis (PRISMA) https://clinicaltrials.ucsf.edu/trial/NCT06940323 AbleNOW https://ablenow.com JOIN: The RealTalk MS Facebook Group https://facebook.com/groups/realtalkms REVIEW: Give RealTalk MS a rating and review http://www.realtalkms.com/review Follow RealTalk MS on X, @RealTalkMS_jon, and subscribe to our newsletter at our website, RealTalkMS.com. RealTalk MS Episode 453 Guest: Dr. Riley Bove Privacy Policy

Today Heidi interviewed Nichelle Sublett, Fertility Coach and founder of Start Asking Fertility, a coaching program for individuals and couples walking through a fertility journey. Here is a little more about Nichelle Sublett and this episode. In Nichelle Sublett's words: "I'd like to discuss why I became a fertility coach, the services I offer, and why working with me will help people feel empowered, supported, and confident while navigating their fertility journey—whether that means trying to conceive naturally, undergoing treatments like IVF, or exploring alternative paths to parenthood.. I want the listeners to truly understand the benefit and value of working with a fertility coach when trying to conceive, and that it's quite different from traditional CBT (Cognitive Behavioral Therapy). I am happy to give updates on my current life and how going through infertility has shaped me as a mother to my two kids. As a fertility coach, I help singles and couples thrive, rather than just survive their unique fertility journeys. I work with clients for a minimum of 8 weeks, and give them emotional support, help them identify lifestyle changes, educate them on holistic options, assist with treatment decisions, help them identify triggers, give them tangible coping strategies, help them build resilience, and prepare them for doctor's appointments. I provide 1:1, confidential coaching sessions to provide extra support, while helping them find connection and make informed decisions. My mantra is to empathize, educate, and empower."   3 Key takeaways from the podcast that listeners will learn today: You don't have to navigate infertility alone. Infertility is a rollercoaster ride of emotions, but support is available. A fertility coach provides emotional, mental, and strategic guidance to help you feel empowered and in control. Listeners will learn why fertility coaching is different from traditional Cognitive Behavioral Therapy. Fertility journeys are unique, and the support should be unique too.   3 Keywords that people would want to search when looking for content that you would provide in this episode: IVF journey Fertility coaching Infertility support   Favorite baby product or new motherhood product? What would you buy for someone who was currently pregnant or a new parent?: Swaddle Me Velcro swaddles and the Haakaa Silicone Pump   Nichelle Sublett, a fertility coach, mom of two IVF miracles, wife, infertility warrior, miscarriage survivor, fertility advocate, Mrs. NC 2018, TEDx Speaker, and the Founder of Start Asking Fertility. I live in Charlotte, NC and I have a master's in medical science and 15 years experience as a medical liaison. I previously worked for two big pharmaceutical companies and a national healthcare system. Website: Start Asking Fertility Instagram: @startaskingfertility and @nichellewsublett TikTok: @nichellewynnsublett YouTube Channel: @startaskingfertility, (1) Nichelle Sublett - YouTube ___________________________________________________________________ We have seats available in Birth Story Academy. Join today for $50 off with code LOVE at https://www.birthstory.com/online-course   Resources: Birth Story Academy Online Course Shop My Birthing Workbooks and Guides   I'm Heidi, a Certified Birth Doula, and I've supported the deliveries of over one thousand parents in my career. On the Birth Story Podcast, I'll take you on a journey through your pregnancy by providing you education through storytelling. I provide high-level childbirth education broken down to make it super digestible for you because I know you are a busy person on the go. Plus, because I am so passionate about birth outcomes, you will hear from many of the top experts in labor and delivery. Connect with Me! Instagram (you will find my Birth Bounds in stories each week!) YouTube Birth Story Boutique Doula + Pregnancy Concierge Services in Charlotte, NC Birth Story Media™ Website Pinterest  

ARREAZA: Today we will expand on other treatments for insomnia in adults. MOIRA: Yes, we spent some time explaining the assessment of insomnia and the first-line treatment, Cognitive Behavioral Therapy for Insomnia (CBT-I). We also mentioned sleep hygiene. You can listen to episode 220 if you want to learn more about that. Medication should be considered a secondary option. The American College of Physicians (ACP) recommends that clinicians use a shared decision-making approach, including a discussion of the benefits, harms, and costs of short-term use of medications, to decide whether to add medication in adults with chronic insomnia disorder in whom CBT-I alone was unsuccessful.  In general, pharmacotherapy is associated with risks of dependence, tolerance, and poorer quality sleep, whereas evidence-based psychotherapies, like CBT-I, result in better long-term outcomes, no drug dependence or polypharmacy risk, and potential cost savings. ARREAZA: Yes, we will start this episode by talking about medications. If you practice primary care, I'm 100% sure that a patient has asked you for “sleeping pills” in clinic. Moira, I know our listeners want to hear about meds. What can you tell about meds to treat insomnia? Moira:We can really split pharmacotherapy for sleep into two categories, OTC, and prescription. And many folks reach for OTC sleep aids before talking to a clinician. When we say OTC sleep aids, we're mostly talking about sedating antihistamines, like diphenhydramine and doxylamine, which are common in products marketed for occasional sleep difficulties. Melatonin is often marketed as a supplement rather than a drug, but it's also widely used OTC in many places, though regulations and quality vary by country. ARREAZA: Exactly. Several studies describe widespread use of these agents among adults and especially older adults, who may face sleep problems related to comorbidities and polypharmacy. Many older adults use OTC sleep aids, often without consulting a healthcare professional or reading labels carefully. Moira: And there's evidence that a substantial share of OTC sleep products contains diphenhydramine or doxylamine—first-gen antihistamines that carry anticholinergic burden, which is particularly relevant for older adults. Melatonin's story is similarly mixed for efficacy. It can modestly affect sleep onset and duration in some populations, especially older adults or circadian rhythm–related sleep problems, but the overall clinical impact is small. What about on the prescription side? DR. ARREAZA: “Z-drugs” are nonbenzodiazepine sedative-hypnotics that enhance the effects of GABA (neurotransmitter). For example, Zolpidem, Zaleplon, eszopiclone. The risks of benzodiazepine use are significant.Benzodiazepine use is associated with increased fall risk across all age groups, and older adults are the highest risk group. That's something we should mention to patients who are requesting a “sleeping pill”, “you may sleep a little better, but you may fall.” A meta-analysis of randomized trials in adults over 60 found that benzodiazepines (vs placebo) caused: 2.6× more psychomotor problems (like falls and car accidents), 3.8× more daytime sleepiness, 4.8× more cognitive impairment. Also, benzodiazepine use is associated with a 34% increased risk of hip fractures (RR 1.34) in older adults. MOIRA: Very significant. Benzodiazepine use is only recommended for four weeks or less due to unproven long-term efficacy and the risk of tolerance, dependence, and misuse. Psychological and physical dependence on benzodiazepines can develop within a few weeks of regular or repeated use. Long-term use is associated with multiple consequences, including dependence, and even increased risk of opioid use.  Dr ARREAZA: And the withdrawal symptoms are very uncomfortable for benzo dependent patients who try to stop benzos on their own. MOIRA: And with the Z-drugs you were mentioning, the FDA has required that all Z-drugs carry a Boxed Warning highlighting the risk of complex sleep behaviors such as sleepwalking and sleep-driving, which can result in serious injuries including death. Medications such as benzodiazepines and antidepressants should be avoided for the treatment of insomnia in older adults whenever possible. DR ARREAZA: There are other prescription options too. Let's talk about low-dose doxepin has shown to have one of the best balances between efficacy and tolerability. When I hear “doxepin” the word “old” comes to my mind. And, yes, it was approved in 1969, it is a tricyclic antidepressant used to treat depression, anxiety, and insomnia. The recommended dose for insomnia is between 3-6 mg. It is not free of side effects, but lower doses seem to be better tolerated. Complex behaviors associated with doxepin: Doxepin may cause out of bed while not being fully awake and do an activity that you do not know you are doing. The next morning, you may not remember that you did anything during the night. You have a higher chance of doing these activities if you drink alcohol or take other medicines that make you sleepy with this medicine. Reported activities include: "sleep-driving", cooking and eating food, talking on the phone, having sex, or sleepwalking. Moira: Another group of medications is dual orexin receptor antagonists (DORAs) such as lemborexant are considered medications with good balance of efficacy and tolerability. No single medication is considered the "best" for all patients. Let's remember that optimal medication depends on patient age, comorbidities, safety considerations, and the type of insomnia (sleep onset vs. maintenance.) MOIRA: Older adults deserve special attention. Although insomnia is not a normal part of the aging process, we do see its prevalence increases with age. CBT-I is effective in older adults and is associated with minimal side effects. We can't talk about sleep meds and older adults without mentioning BEERS criteria, which is a guideline which aims to reduce adverse drug events and polypharmacy by highlighting drugs with risks outweighing benefits, urging safer alternative. In sleep medicine and insomnia management for older adults, Beers Criteria explicitly flag sedating antihistamines (e.g., diphenhydramine, doxylamine) as potentially inappropriate for elderly patients due to anticholinergic burden and adverse effects such as delirium, cognitive impairment, sedation, and falls risk. MOIRA: Yes! So again, I want to highlight that the first line treatment should always be CBT-I, but when this isn't working or isn't an option, then think about adding pharmacotherapy. We should really be sharing that OTC options should only be for occasional sleep trouble, not chronic insomnia. Also, be mindful of age-related risks. And consider melatonin with caveats, melatonin may be an option with generally small sleep-onset effects but again, short-term use and quality matters. To close, OTC sleep aids fill a real need for short-term relief, but they're not a substitute for diagnosis and evidence-based treatment of insomnia, especially in older adults where safety is a particular concern. And our prescription options like benzos, z drugs, antidepressants, aren't much better. DR. ARREAZA: Primum non nocere (“first, do no harm”) is a chief consideration in insomnia management. Sleep is foundational to health, and I hope this helps our colleagues feel more confident in addressing it.If you found this helpful, share it with a friend or colleague and rate us wherever you listen to us. This is Dr. Arreaza, signing off. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!  _____________________ References: Morin, C. M., & Buysse, D. J. (2024). Management of Insomnia. The New England journal of medicine, 391(3), 247–258. https://doi.org/10.1056/NEJMcp2305655 Healy, W. J., Khayat, R. N., & Kwon, Y. (2024). Insomnia: Advancements and Limitations of Current Management Strategies. American family physician, 109(2), 107–108. https://pubmed.ncbi.nlm.nih.gov/38393789/ Drugs.com. (2025, August 6). Doxepin. Retrieved April 15, 2026, from https://www.drugs.com/doxepin.html Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!

PURCHASE THIS PODCOURSE! If you are a therapist or counselor looking for continuing education, check out my NBCC Approved $5 Podcourses and other continuing education offerings.Plus, get your first Podcourse half off. In this 60-minute NBCC-approved podcourse, I'm joined by Michelle Witte, RP, to explore how Cognitive Behavioral Therapy can be effectively adapted for adults with ADHD, especially when challenges with executive functioning interfere with insight, follow-through, and real-life change. We discuss how ADHD often presents beyond the common stereotypes, especially in adults and adolescents who may struggle with time blindness, disorganization, emotional dysregulation, task initiation, and inconsistent follow-through. We also explore why traditional CBT may fall short when it does not account for executive functioning difficulties, and how therapists can modify their approach to better support implementation, accountability, and sustainable progress. This training supports therapists in recognizing the cognitive, emotional, and behavioral patterns commonly associated with ADHD, understanding how executive functioning deficits affect treatment engagement, and applying practical CBT-based strategies that improve follow-through in everyday life. Our hope is that you'll walk away with fresh strategies you can integrate into your clinical work right away, and you can also earn one NBCC continuing education contact hour by completing this Podcourse.

Episode 220: Approach of Insomnia in Adults     ARREAZA: Today we are going to talk about how to approach sleep issues in adults — from the initial assessment all the way through treatment. And I think what is going to surprise a lot of our listeners is the changes in management in recent years, especially what is recommended as first-line therapy. So, let's jump right in. MOIRA: Sleep is one of those topics that touches every specialty, but Primary Care in particular, so I'm excited to dig into this. ARREAZA: Let's start with the big picture–statistics. How common are sleep problems in adults? MOIRA: Incredibly common. Chronic insomnia affects roughly 10% of the general population, and that number has only grown in recent years . During the COVID-19 pandemic, for instance, prevalence rates of insomnia symptoms were reported globally at 20 to 45% (wow). And, importantly, those sleep problems did not simply resolve once infection rates dropped, insomnia symptoms and fatigue have continued even as mood improves in people recovering from COVID-19 infection.  ARREAZA: Incredible that we are in 2026 and still talking about COVID-19. And we clinicians need to understand that insomnia isn't just an annoyance. It has long-term consequences. Also, financially, insomnia causes direct and indirect costs of up to $100 billion each year. MOIRA: Exactly. Insomnia is both a risk factor for, and a symptom of, several psychiatric disorders, and it is a predictor of death by suicide, making it an important target for intervention. It's highly comorbid with medical and psychiatric disorders and is associated with significantly increased healthcare utilization and costs. People with insomnia also perform more poorly on complex cognitive tasks. So, we're talking about a condition that affects cognition, mental health, physical health, and quality of life. ARREAZA: And yet, it still gets overlooked in many clinical encounters. Let's be honest, dealing with insomnia is not easy on patients… and doctors! MOIRA: That's the paradox. Primary care practitioners are often poorly informed about sleep disorders, which remain underdiagnosed and sub-optimally managed. In one Italian epidemiological survey, insomnia was reported by 64% of over 3,000 patients interviewed under general practitioners, with 20% reporting both nighttime and daytime symptoms. So, the patients are there, we're just not always asking the right questions or knowing what to do when they tell us about their sleep. ARREAZA: Great. Let's talk about assessment. In my experience, we need a full encounter to address sleeping issues. Patients tend to mention insomnia as you start walking out of the room. Let's say a patient tells us, "Doctor, I can't sleep," how de we approach this? MOIRA: The first step is a comprehensive sleep and health history. Clinical assessment should describe the sleep disturbance and elicit etiological and exacerbating factors. You want to understand the nature of the complaint; is it difficulty to fall asleep, difficulty staying asleep, early morning awakening, or some combination? How long has it been going on? What's the impact on daytime functioning? ARREAZA: That's why I think it should be addressed in a full encounter, if possible, because understanding the full extent of the problem requires time. We need to think about contributing factors too. MOIRA: Absolutely. Factors such as medications, medical disorders, and psychiatric disorders can all increase the risk for insomnia. You need to screen for comorbid conditions, depression, anxiety, PTSD, and chronic pain. Insomnia is actually both a risk factor for and a symptom of several psychiatric disorders. You also want to rule out other primary sleep disorders. Comorbid insomnia and sleep apnea, for example, is highly prevalent and debilitating. If someone has both insomnia and obstructive sleep apnea, treating only one without addressing the other may lead to suboptimal outcomes. ARREAZA: Now that you mention comorbid conditions, let's mention nocturia. I feel like it's very common with my older patients. MOIRA: Great point. Nocturia (waking from sleep at night to void) and chronic insomnia frequently co-exist in older adults, contributing synergistically to sleep disturbance. Treatments typically target either nocturia or insomnia rather than simultaneously addressing the shared mechanisms for these disorders. There's emerging work on integrated cognitive-behavioral treatment programs that address both conditions simultaneously, which is a promising direction. But at minimum, you should be asking about it, because if nocturia is driving the awakenings, you need to address that as part of the treatment plan. _____________________ References: Baglioni, C., Altena, E., Bjorvatn, B., Blom, K., Bothelius, K., Devoto, A., … & Riemann, D. (2019). The European Academy for Cognitive Behavioural Therapy for Insomnia: An initiative of the European Insomnia Network to promote implementation and dissemination of treatment. Journal of Sleep Research, 29(2). https://doi.org/10.1111/jsr.12967 Becker, P. (2022). Overview of sleep management during COVID-19. Sleep Medicine, 91, 211-218. https://doi.org/10.1016/j.sleep.2021.04.024 Bramoweth, A., Germain, A., Youk, A., Rodriguez, K., & Chinman, M. (2018). A hybrid type I trial to increase Veterans' access to insomnia care: study protocol for a randomized controlled trial. Trials, 19(1). https://doi.org/10.1186/s13063-017-2437-y Brewster, G., Riegel, B., & Gehrman, P. (2018). Insomnia in the Older Adult. Sleep Medicine Clinics, 13(1), 13-19. https://doi.org/10.1016/j.jsmc.2017.09.002 Conroy, D. and Ebben, M. (2015). Referral Practices for Cognitive Behavioral Therapy for Insomnia: A Survey Study. Behavioural Neurology, 2015, 1-4. https://doi.org/10.1155/2015/819402 Dzierzewski, J., Griffin, S., Ravyts, S., & Rybarczyk, B. (2018). Psychological Interventions for Late-Life Insomnia: Current and Emerging Science. Current Sleep Medicine Reports, 4(4), 268-277. https://doi.org/10.1007/s40675-018-0129-0 Fung, C., Huang, A., Markland, A., Schembri, M., Martin, J., Bliwise, D., … & Vaughan, C. (2024). A multisite feasibility study of integrated cognitive‐behavioral treatment for co‐existing nocturia and chronic insomnia. Journal of the American Geriatrics Society, 73(2), 558-565. https://doi.org/10.1111/jgs.19214 Gardner, D., Turner, J., Magalhaes, S., Rajda, M., & Murphy, A. (2024). Patient Self-Guided Interventions to Reduce Sedative Use and Improve Sleep. Jama Psychiatry, 81(12), 1187. https://doi.org/10.1001/jamapsychiatry.2024.2731 Garland, S., Vargas, I., Grandner, M., & Perlis, M. (2018). Treating insomnia in patients with comorbid psychiatric disorders: A focused review. Canadian Psychology/Psychologie Canadienne, 59(2), 176-186. https://doi.org/10.1037/cap0000141 Germain, A., Wolfson, M., Brock, M., O'Reilly, B., Hearn, H., Knowles, S., … & Wallace, M. (2023). Digital CBTI hubs as a treatment augmentation strategy in military clinics: study protocol for a pragmatic randomized clinical trial. Trials, 24(1). https://doi.org/10.1186/s13063-023-07686-2 Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!

Broadcast from KSQD, Santa Cruz on 4-16-2026: Dr. Dawn opens with a follow-up from an email from Maryland about a friend in Switzerland, who has ongoing neurological and gastrointestinal symptoms. She reviews the earlier effort to connect him with functional-medicine resources in Switzerland, then focuses on a new observation that the patient may have had multiple parasitic infections during travel in Europe. Dawn agrees that this may have left a major gap in the workup and says that, in puzzling neurologic cases, a sleep-deprived EEG can sometimes reveal a “fingerprint” of brain-based dysfunction even if the patient is not actively having symptoms during the test. Dr. Dawn says that for people over 60 who have never had a heart attack or stroke, daily baby aspirin is no longer considered a good routine preventive measure because the bleeding risks, especially gastrointestinal bleeding, can outweigh the cardiovascular benefit. She makes the distinction that aspirin may still make sense for secondary prevention in people who already have established cardiovascular disease. She next reviews several medications that she thinks many older adults should reconsider. She explains that phenylephrine, which replaced easier access to pseudoephedrine in many cold remedies, has been found to work no better than placebo . She also says Colace is not very effective, and she strongly advises older adults to avoid Benadryl because it accumulates with age, increases fall risk, and may be associated with cognitive decline. She adds that beta blockers are no longer preferred first-line treatment for uncomplicated hypertension in many older patients, and that medications targeting the angiotensin pathway are generally favored instead. Dr. Dawn introduces Mira Achilles in the studio, describing her as her excellent administrative assistant. Mira explains that she gathered health questions from peers from her college world. Mira asks what best supports focus for someone with ADHD working at a desk job. Dr. Dawn says the two evidence-based pillars are cognitive behavioral therapy and exercise. She walks through practical strategies including using calendars, reminders, index cards, and to-do lists; sorting tasks by urgency and importance; breaking large projects into smaller steps; creating small reward loops by checking off progress; and deliberately reducing distractions in the work environment.. She emphasizes that movement and exercise improve attention and executive function, and that ADHD management often improves when sleep timing is stabilized. Another of Mira's peers asks whether women should avoid very cold showers or ice baths during the luteal phase or around menstruation. Dr. Dawn says the answer is not absolute, but she cautions that cold exposure can hit women differently depending on hormonal state. She notes that the luteal phase may make vasoconstriction and cold sensitivity more pronounced, and she raises concerns about the physiologic stress of cold immersion, including possible adverse effects on circulation and rewarming. Her overall tone is cautious rather than enthusiastic, especially for people who are already prone to feeling chilled or reactive. Another contributor asks why some people faint when seeing needles, blood, or medical procedures. Dr. Dawn explains the vasovagal response: a reflex in which blood pressure and heart rate suddenly drop, reducing blood flow to the brain. She offers simple countermeasures such as crossing the legs, tightening muscles, squatting, or using hand-grip tension to help push blood back toward the brain and prevent passing out. Dr. Dawn closes by asking whether cortisol is a “good” or a “bad” hormone. Dr. She answers that cortisol is essential: it helps regulate daily rhythms, energy balance, and the broader hormonal system, so it is not something to think of as inherently harmful. At the same time, she says problems arise when cortisol is chronically dysregulated or excessive, so the goal is to maintain a healthy rhythm and avoid overwhelming the adrenal system. Please go to KSQD.org and donate to support Ask Dr. Dawn on KSQD.

In episode 533 I chat with Dr Steven Phillipson and his patient Sean. Steven is a licensed clinical psychologist who specialises in Cognitive-Behavioral Therapy for OCD. Steven is the Clinical Director at the Center for Cognitive Behavioral Psychotherapy in New York. He is joined by one of his patients, Sean, who has kindly agreed to share his story. We discuss Sean's OCD story, Steve discusses the idea of Sarnos (psychosomatic symptoms), Sean's difficulty bragging and worrying about Sarnos, exposure and response prevention therapy (ERP), the idea of the brain voice and the gatekeeper voice, and much more. Hope it helps. Show notes: https://theocdstories.com/episode/steve-and-sean-533 The podcast is made possible by NOCD. NOCD offers effective, convenient therapy available in the US and outside the US. To find out more about NOCD, their therapy plans and if they currently take your insurance head over to https://go.treatmyocd.com/theocdstories Join many other listeners getting our weekly emails. Never miss a podcast episode or update: https://theocdstories.com/newsletter 

What do you do when life doesn't go according to plan?In this episode of The Running Wine Mom, Samantha sits down with Dr. Rachel Goldman, clinical psychologist, speaker, and author of When Life Happens, to talk about what it really means to manage stress, build confidence, and move forward when life feels overwhelming.From burnout and mom guilt to confidence and mindset shifts, this conversation is packed with practical tools rooted in cognitive behavioral therapy (CBT) — but explained in a way that actually feels doable.You'll hear: Why “starting before you feel ready” changes everything  The truth about burnout (and why it's not a badge of honor)  How running inspired the title When Life Happens The connection between thoughts, emotions, and behavior  Simple daily mindset shifts that can help you feel better immediately If you've ever felt like you're holding it together on the outside while unraveling on the inside — this episode will meet you right where you are.

After a period away, I'm back. In this personal reflection episode, I share what years of running this site and podcast have taught me — what the numbers reveal about anxiety sufferers, why audio outperforms everything else, the ADHD connection, what actually helps, and a message of hope: one day at a time, don't give up.

Cognitive-Behavioral Therapy tools can help you clear the noise that blocks your purpose.How can you use CBT tools to clear away the ‘noise'?How can you correct distorted thinking to bring your life's purpose into focus?Join me, Dr Julie Osborn, as I share with you the many fascinating ways CBT tools can help you discover and clarify your life purpose. Click to listen now!Visit us on Instagram at MyCBTPodcastOr on Facebook at Dr Julie OsbornSubscribe to the podcast at Apple PodcastsEmail us at mycbtpodcast@gmail.comFind some fun CBT tools at https://www.mycbt.store/Thanks for listening to My CBT Podcast!

Dr. Hoffman continues his conversation with Dr. David Clarke, president of the Psychophysiologic Disorders Association.

Dr. David Clarke, president of the Psychophysiologic Disorders Association, details the link between stress and chronic pain and the scope of brain-generated symptoms. Clarke says many patients have symptoms not explained by disease or injury, estimating about 20% of U.S. adults (about 50 million) live with chronic pain, with costs estimated at $650 billion, and notes clinicians are often not trained to evaluate psychosocial stressors. He describes clues that pain is brain-generated (e.g., multiple long-lasting or shifting symptoms, lack of objective nerve damage) and a broad symptom spectrum from migraines and IBS to pelvic pain and rashes. Clarke discusses adverse childhood experiences, triggers, personality traits, and repressed emotions, cites randomized trials showing “pain relief psychology” can reduce pain and change MRI findings, and shares resources including a clinician directory, self-assessment quiz, and the Curable app. 

Join me this week for a deep dive into the art and science of Satya—speaking and acting from your authentic truth. In this episode, we blend practical psychology with spiritual wisdom to show how truth-telling can transform mental health, relationships, and everyday choices. You'll hear how Cognitive Behavioral Therapy helps uncover automatic thoughts that fuel inauthentic behaviors, and how DBT's DEARMAN skills can help you request what you need while preserving connection. We'll explore Interpersonal Neurobiology to understand how naming our feelings can regulate the nervous system, and how Internal Family Systems encourages curiosity about the parts inside us that resist honesty—so Self can lead with clarity and compassion. Plus, we'll ground the conversation in spiritual wisdom about truth-telling from traditions around the world. You will find actionable steps, real-life scenarios, and guided reflections to practice Satya right away—whether you're setting boundaries at work, navigating conflict at home, or simply learning to show up as your truest self. Tune in for practical tools and a thoughtful path toward greater peace and resilience.

BIO: A Nigerian-American psychotherapist, Agatha Peters is the founder of Beautiful Sunshine Therapy and the author of Trapped in Their Script: Reclaim Your Life from Narcissistic Parents & Cultural Expectations. She is dedicated to helping adult children of narcissistic parents, especially those from collectivist cultures, where family loyalty often overshadows individual well-being. Having experienced the healing power of therapy herself, she is passionate about helping others discover the same transformation and offers guidance on embracing one's identity while respecting cultural ties. SOCIAL MEDIA LINKS: Website: https://beautifulsunshinetherapy.com LinkedIn: https://www.linkedin.com/in/agatha-peters-6209659a Facebook: https://www.facebook.com/share/19AW9BHBNM/?mibextid=wwXIfr Instagram: https://www.instagram.com/beautifulsunshinetherapy?igsh=amR0dGhkbXVtbWQ1&utm_source=qr   Credits: Host: Taryell Simmons Guest: Agatha Peters Music: Will Maker Production: RISE Urban Nation Unite. Empower. Ignite.Thank you for tuning into the RISE Urban Nation Podcast, where we go beyond conversation to fuel a movement of unity, empowerment, and transformation across the Black and Pan-African community. Each episode dives deep into the stories of entrepreneurs, innovators, and changemakers shaping culture, business, and legacy.Hosted by Taryell Simmons, a leader in Equity, Diversity, and Inclusion, the show blends storytelling with strategy to help you amplify your voice, grow your brand, and lead with purpose.Why Subscribe to RISE Urban Nation?✨ Inspiring Stories: Learn from influential Black and Pan-African leaders making an impact.

Guest Bios Dr. Suhas Kshirsagar, BAMS, MD (Ayurveda) One of the most academically accomplished Ayurvedic physicians in the Western world. Former personal physician to Maharishi Mahesh Yogi. Bestselling author of Change Your Schedule, Change Your Life and co-author of Awakened Sleep. Faculty at numerous integrative medicine programs. Trained in both classical Ayurvedic medicine and modern clinical research. His work bridges 5,000 years of Vedic wisdom with cutting-edge neuroscience and AI-driven health research. Renowned globally for his clinical expertise and his ability to make the ancient tradition accessible, scientific, and immediately practical. Dr. Sheila Patel, MD Board-certified family medicine physician and a leading voice in integrative health. Former Chief Medical Officer of the Chopra Center. Co-author of Awakened Sleep. Dr. Patel's clinical practice synthesizes conventional medicine with Ayurvedic principles, meditation, and mind-body approaches. She has spent decades helping patients understand the connection between emotional regulation, sensory awareness, and physical health — with sleep as the connective thread. Brought to you by MTE — More Than Energy, the performance formula designed for those who live life at full resonance. Trusted by top performers worldwide, MTE blends adaptogens, nootropics, and essential minerals to fuel focus, vitality, and flow — without the crash.  Code Michael Elevate your day, sharpen your mind, and feel More Than Energy. 15% OFF YOUR ORDER:: https://getmte.com/products/mte-daily-energy-wellness?ref=MICHAEL Key Themes & Timestamps  [00:00] Introduction — launching Resonance, the long tail of a book [02:28] What is Awakened Sleep? The Vedic perspective on sleep as a journey into consciousness [06:13] Modern science validates ancient wisdom — the convergence [08:13] The doshas explained — Vata, Pitta, Kapha and your sleep constitution [14:24] Universal sleep principles — temperature, light, timing, and the Stanford AI study [17:19] Personalized sleep — why one size doesn't fit all [20:00] The nervous system connection — parasympathetic tone and sensory overload [23:47] Your evening meal is your sleep prescription [25:50] The world has changed more since 1992 than in the previous thousand years [28:14] Orthosomnia — the new tech-induced sleep disease [29:09] Email apnea and text apnea — we literally stop breathing [30:15] Somniphobia — the fear of being alone in the dark (and why loneliness is the real insomnia) [37:47] Breath as medicine — the yogic prescription for sleep [40:11] Mantra, sound, and the neuro-associative conditioning of sleep [42:27] Creating your evening routine — the practice Michael is starting tonight [45:05] The dress rehearsal for dying — sleep as a journey into consciousness [51:17] Awakened Sleep as meditation's companion — the fourth state of consciousness [56:04] Geography, doshas, and the places that heal us [59:56] Vedic astrology, the eclipse, and the chapter we're entering [1:02:49] Closing — guiding us home in a noisy world Key Quotes Dr. Suhas: "We are doing a dress rehearsal of dying every night. We go to the same place where we were before we were born and long after we will be gone." "Sleep outweighs diet and exercise. If you rank lifestyle things, sleep is even higher ranked than diet and exercise and loneliness." "Orthosomnia — about 40% of Gen Z adults are experiencing sleep anxiety because of the gadgets they are wearing." "Where your attention goes, that's where the energy is flowing." "These techniques are not free. They are very expensive — because the most expensive commodity right now is me time." "An introspective sage is awake when the rest of the world is sleeping." — Bhagavad Gita Dr. Sheila: "Sleep is an active process. It's not just rest — it's an active rest." "So much of depression, anxiety is that disconnect from nature, disconnect from community. Everyone's all in their own individual bubbles." "Pick the weeds, plant some seeds, water them with gratitude." "We have so many tools within us — and with our breath, it's free." Michael: "I think a lot of us as humans have lost our way with all of the conflicting signals. And it's hard in a noisy world to find true signal that reminds us of who we are and how we can find our way home." Resources Mentioned Awakened Sleep by Dr. Suhas Kshirsagar & Dr. Sheila Patel Change Your Schedule, Change Your Life by Dr. Suhas Stanford Medicine AI Sleep Study (January 2025) — 65,000 participants, 600,000 hours of sleep data, predicting 130+ health conditions Oura Ring — wearable sleep tracking Vedic Meditation / Mantra practice Temescal (traditional sweat lodge) ceremony Bhagavad Gita — "Yānishā sarva-bhūtānāṁ tasyāṁ jāgarti saṅyamī" Rathri Sukta — Vedic hymn to the twin sisters Usha (dawn) and Nisha (dusk) Cognitive Behavioral Therapy for Insomnia (CBT-I) Connect Dr. Suhas Kshirsagar: [website] | [Instagram]  Dr. Sheila Patel: [website] | [Instagram]  Michael Trainer: michaeltrainer.net | @michaeltrainer | Resonance Podcast Pre-Order Resonance Resonance: The Art and Science of Human Connection arrives May 5, 2026 from BenBella Books. Foreword by Steven Pressfield, author of The War of Art. "Outstanding. I wouldn't change a word." — Steven Pressfield  Companion Substack Read Michael's full essay on this conversation: "The Dress Rehearsal for Dying: What Vedic Sleep Science Reveals About Why We Can't Connect" — exploring how orthosomnia, somniphobia, and the loneliness epidemic collide with the Resonance framework and the Seven Pillars of authentic connection. https://substack.com/@michaeltrainer Michael Trainer has spent 30 years learning from Nobel laureates, neuroscientists, and wisdom keepers worldwide. He's the author of RESONANCE: The Art and Science of Human Connection (March 31, 2026), co-creator of Global Citizen and the Global Citizen Festival, and host of the RESONANCE podcast.Featured in Forbes, Inc, Good Morning America. Follow on YouTube

Meet Richard Lam-- Master TEAM CBT Teacher and Therapist! Today we chat with Richard Lam. Richard is a licensed Marriage and Family Therapist in private practice in Mountain View, California. He is a graduate of Palo Alto University. He currently provides short-term therapy for anxiety, OCD, habits/addictions, depression, and relationship concerns using Cognitive Behavioral Therapy. Richard also trains other therapists in David Burn's model of CBT called TEAM-CBT Therapy. He is a certified Level 5 Master Therapist and Trainer in TEAM-CBT Therapy.  And today, Richard has gifts for you! They are fantastic! See below! I began by asking Richard how he got interested in teaching. When he was first learning, he was tutored by Dr. Angela Krumm, an advanced TEAM CBT practitioner and one of the three founders of the Feeling Good Institute. He was loving the training, but one day she said, "That's all I can teach you. Now you have to start teaching!"  And that started the wagon rolling down the hill. Richard is particularly interested in developing free self-help tools for patients, but also runs a special training class for TEAM CBT therapists who themselves want to become trainers. It meets in-person at the FGI office on Mondays from 12 to 2 PM. If interested, contact Richard (contact information is at bottom of show notes.) Richard is one of our most articulate TEAM CBT teachers, and is renown for some of his live demonstrations of specific techniques, like Forced Empathy. He has created a series of multi-page interactive teaching guides for a variety of techniques, so you can learn exactly how to do the Double Standard Technique, or the Externalization of Voices in a simple, clear, step-ty-step manner. Here are links to several examples. Check them out and feel free to share them with your patients if you are a TEAM therapist.  These links are all kick ass! Check them out and do the exercises. You'll be glad you did! Link to Double Standard Technique Link to Externalization of Voices  Link to Externalization of Resistance Link to I Feel Statements, Part 1 Link to I Feel Statements, Part 2 Link to Feared Fantasy Link to Forced Empathy Link to Forced Empathy Handout Link to Future Projection, for Habits Link to Paradoxical Ultimatum Richard tells us that mental health works a lot like physical health. When we don't regularly care for our bodies, things start to deteriorate and the same is true for our minds. These tools give you a way to keep nurturing your mental health so you can maintain a strong, healthy mind. Richard and I also discussed Acceptance--one of the most difficult concepts for patients and therapists alike to "get." I was delighted to learn he has a five-point plan to help people grasp this concept. Richard's Five Steps to Acceptance 1. The Win-Win Principle: How can I see this loss as a win? In high school, Richard had a patient whose heart was set on making the varsity basketball team, and was heartbroken when he only made the junior varsity team. But then he got to thinking that it would be fun to be the start on the JV team because his best friend is also going to be in JV. He relaxed and started to enjoy his practices with the team.  And He was promptly promoted to the varsity team!  2. Remember the butterfly effect!  Richard described getting angry and frustrated when he was late for an important appointment, and the car in front of him was moving slowly and caused a delay at a red light. His first impulse was to get angry and insist it SHOULDN'T have happened. But then, in reflection, he thought: "Wait a minute. This delay will change the entire trajectory of the rest of my life. And who knows, this could have save my life from some future tragedy if the trajectory of my life had been on time."  3, Growth mindset I have always thought of this important idea in simple terms. There is really no such "thing," from a Buddhist perspective, as "success" or "failure." These are just experiences. But often things do not turn out as one hoped. Instead of caving in, giving up, or feeling depressed or frustrated, although those are perfectly reasonable human experiences, you can accept your failure and view it as an opportunity for growth and learning. Our 9 month old grandson has reminded me that when we are learning to walk, we "fail" constantly, falling over, etc. But these are steps in learning that eventually culminates in the ability to walk--which is a miracle! 4. The spiritual view Acceptance can be thought of as letting go of judgement. Richard treated a woman who was angry at God because she could not have children, and she had always dreamed of having a big family. But from a medical perspective, her anger and constant agitation were actually the main reason she couldn't get pregnant. Shen she began working on reducing her anger using TEAM CBT, she was able to relax, and accept her fate with greater in peace. And then she suddenly got pregnant!  I, David, have seen this on many occasions. Check out Podcast #7f9, one of our most popular podcasts ever, with Daisy: "What is the Secret of a Meaningful Life?" Or Podcasts 268 - 269, featuring live work with our beloved Dr. Carly Zankman. Or #349: "What if my family rejects me?" All of these podcasts were amazing, and resulted in rapid pregnancies! 5. Empathy vs anger Richard described getting VERY angry when someone broke into his car and stole a bunch of stuff, but then asked himself why they did it. He realized that they were probably struggling and desperate for money--for drugs, for food, for family. Understanding someone's story can help lower the anger that you feel. Richard, Rhonda, and David