Podcasts about disorders

Subscribe on Patreon and hear this week's full patron-exclusive episode here: https://www.patreon.com/posts/135737340 Beatrice, Artie and Tracy discuss the potential impacts of a new Trump executive order called “Ending Crime and Disorder on America's Streets,” which threatens to dramatically expand involuntary psychiatric commitment and make it easier for the government to disappear people off the streets, allegedly in the name of “compassion.” Runtime 1:51:47 Note: We're back! Thank you to everyone for all the well wishes and many kind messages during our parental leave. We have a lot coming together soon processing current events and reacting to some big developments that happened while we were away. As we ramp production back up we'll be prioritizing the patron feed first to make sure patrons get a full new episode every week. Get Health Communism here: www.versobooks.com/books/4081-health-communism Find Tracy's book Abolish Rent here: www.haymarketbooks.org/books/2443-abolish-rent

In episode #87 Andy Anderson sits down with us to talk about Disorder's "Distress" Full Length Video, Diego Todd For Stussy part, Stevie Williams Vs Eric Koston & Nike SB and much more! Become a Channel Member & Receive Perks: https://www.youtube.com/TheNineClub/joinNew Merch: https://thenineclub.com Sponsored By: AG1: Get a free 1-year supply of immune-supporting Vitamin D3 + K2 and 5 travel packs with your first purchase. https://drinkag1.com/nineclubLMNT: Grab a free Sample Pack with 8 flavors when you buy any drink mix or Sparkling. https://drinklmnt.com/nineclubWoodward: Save $100 off summer camp with code NINECLUB. Join Chris, Kelly, Jeron, and Roger at Woodward West Adult Camp, Aug 11-16. https://www.woodwardwest.com & https://www.woodwardpa.comBear Mattress: Delivered to your door with easy setup. Use code NINECLUB for 40% off your order. https://www.bearmattress.comMonster Energy: https://www.monsterenergy.comSkullcandy: https://www.skullcandy.comYeti: https://www.yeti.comEmerica: Get 10% off your purchase using our code NINECLUB or use our custom link. https://emerica.com/NINECLUB Find The Nine Club: Website: https://thenineclub.com Instagram: https://www.instagram.com/thenineclub X: https://www.twitter.com/thenineclub Facebook: https://www.facebook.com/thenineclub Discord: https://discord.gg/thenineclub Twitch: https://www.twitch.tv/nineclub Nine Club Clips: https://www.youtube.com/nineclubclips More Nine Club: https://www.youtube.com/morenineclub I'm Glad I'm Not Me: https://www.youtube.com/chrisroberts Chris Roberts: https://linktr.ee/Chrisroberts Timestamps (00:00:00) Nine Club Live #87 (00:00:10) Andy Anderson is in for Dubs! (00:10:00) Mitchie Brusco sighting (00:12:00) Chris wants to scratch coping (00:15:00) The Nine Club Classic is this weekend (00:22:00) Jim Carey sightings (00:24:00) TJ Rogers Bones in Toronto (00:47:00) Stevie Williams Vs Eric Koston and Nike SB (01:09:00) Diego Toddy for Stussy (01:35:00) Disorder (02:19:00) Thank you and see you at the Nine Club Classic Learn more about your ad choices. Visit megaphone.fm/adchoices

Recorded 2025-07-31 03:01:53

On this episode of The Dr. Hyman Show, we're exploring the emerging science of metabolic psychiatry. My guest, Dr. Iain Campbell, is a researcher at the University of Edinburgh and someone who has lived with bipolar disorder himself. He brings a rare dual perspective as both a scientist and a patient to this critical conversation.  Together, we discuss what's really driving psychiatric conditions like bipolar disorder and why a systems-based approach may hold the key to meaningful recovery. Catch our full conversation on YouTube here - https://youtu.be/YCcZb2H2Ceg We unpack: • What it means when mental health symptoms start in the body—not just the brain • How to tell if metabolism, sleep, or inflammation are driving your mood swings • Why seasonal changes impact energy and mood, and how you can stay steady year-round • When keto might help where meds haven't, and what to know before trying it • How to catch metabolic red flags before they affect your mental health When we shift how we see mental health, real healing becomes possible. There are answers, and this episode can help you find them. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman's Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Resultshttps://drhyman.com/pages/hyman-hive This episode is brought to you by Sunlighten, Paleovalley, AirDoctor and LMNT. Visit sunlighten.com and save up to $1400 on your purchase with code HYMAN. Get nutrient-dense, whole foods. Head to paleovalley.com/hyman for 15% off your first purchase. Get cleaner air. Right now, you can get up to $300 off at airdoctorpro.com/drhyman. Get a free LMNT Sample Pack with any order—just head to drinklmnt.com/hyman.

Trump signed an executive order last week that could fundamentally reframe the way the federal government deals with homelessness. Titled “Ending Crime and Disorder on America's Streets,” the order pivots away from housing-first strategies and toward public safety and mandatory treatment. That includes prioritizing funding for states and cities that ban urban camping, loitering, and open drug use, and it supports civil commitment — involuntary hospitalization for those with severe mental illness or addiction. Harm reduction programs are effectively defunded under this order, and treatment becomes a prerequisite for federal help.This didn't get a lot of attention in the media. That's a mistake. Homelessness is one of the most visible problems in American cities, and it's not going away. I've lived in Oakland, San Francisco, and Austin — three cities that have all struggled mightily with this issue. San Francisco in particular is the worst I've seen. It's not hyperbole to say that its homelessness crisis overshadows the city's stunning architecture and rich culture. Visitors walk away talking about tents, not the Golden Gate Bridge.Politics Politics Politics is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.This isn't a lecture about policy. I don't think there's an easy solution. From everything I've read and seen, roughly half of people living on the streets are there because of financial collapse — bad luck, bad decisions, and no safety net. The other half, though, don't want to reenter society. Some of them are dangerous, many are mentally ill, and addiction is everywhere. That's especially true in places like the Bay Area, where cheap or even free drugs are plentiful, and the spiral from one substance to the next ends in death more often than we acknowledge.Even in liberal cities, the political lines are shifting. When I moved to Austin in 2021, the city had rescinded its ban on urban camping. The results were immediate: tents on sidewalks, more street homelessness, and public parks taken over. A citywide referendum eventually reinstated the ban — not because Austin became more conservative, but because people across the political spectrum wanted cleaner streets. They didn't necessarily care how it happened. That's the political space Trump's executive order moves into.It's controversial, yes. And there are real concerns about forcing treatment and stripping funding from programs that do help some people. But the public mood is changing. People are frustrated. They want their cities back, and they're running out of patience for ideological purity tests. Trump, love him or hate him, is filling a leadership vacuum here. I don't know if his order will work — or if it'll be implemented at all in places that oppose him. But I do think it's a sign that this issue is far from settled, and it's about to get a lot more attention.Chapters00:00:00 - Intro00:03:09 - Trump's Homelessness Plan00:14:56 - Update00:15:18 - EPA Rollbacks00:20:09 - North Carolina00:23:12 - Epstein00:26:58 - Interview with Dan Turrentine00:59:56 - Wrap-up This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.politicspoliticspolitics.com/subscribe

Fear Is Not a Disorder | Breaking Free from OCD, Anxiety & StressFear is a normal human emotion—not a disease. Learn how rethinking fear can transform your approach to anxiety, OCD, and panic recovery. It's time to stop managing symptoms and start healing.

In this episode, Karen shares her journey through recurrent miscarriage and infertility, shedding light on the challenges posed by a hidden blood clotting disorder. She candidly discusses the emotional toll of baby loss and the importance of self-advocacy in navigating fertility care. Discover how art and writing have been vital in her process of grief and healing.

In this episode, we break down what veterans need to know about  a VA disability claim for seizure disorders. Whether you're dealing with epilepsy, non-epileptic seizures, or service-connected neurological conditions, understanding how the VA rates seizures is crucial for securing the benefits you deserve.We'll cover the different types of seizure disorders recognized by the VA, how VA rating percentages are determined, what medical evidence may support your claim, and how to handle VA C&P exams for neurological conditions. You'll also learn about secondary service connection and how seizure disorders can be linked to other service-related conditions, including traumatic brain injuries (TBIs).

Bear in Mind Ep. 17What happens when the body shuts down—but nothing shows up on a scan?This week, we explore Functional Neurological Symptom Disorder (FND)—a complex and often misunderstood condition that causes real symptoms like seizures, paralysis, or loss of speech, with no detectable neurological cause.Our guest, Dr. Curt LaFrance, double-boarded in psychiatry and neurology, helps break down what we do (and don't) know about FND. From diagnosis to treatment and stigma, we cover the science, the struggle, and the hope.

President Trump has signed a new executive order aiming to address homelessness, public disorder, and addiction. Titled "Ending Crime and Disorder on America's Streets," this order seeks to make it easier for states and cities to remove homeless individuals from public spaces and direct them into treatment programs, potentially including involuntary commitment.But what are the true implications of this new policy? We break down the key provisions, including the redirection of federal funding away from "Housing First" models, efforts to reverse judicial precedents, and the administration's focus on public safety. We also explore the significant backlash from homeless advocates and civil liberties groups who argue the order criminalizes homelessness and mental illness.

August is here — and so is Make a Splash for CASK, our annual global fundraiser to raise awareness and fuel therapeutic development for CASK gene disorders.In this episode of The ROAR, Project CASK co-founder Hitomi Kubo invites listeners behind the scenes to learn how research, community, and creativity come together in our mission to find treatments and a cure for CASK. Using a memorable banana split ice cream sundae metaphor, Hitomi walks through the essential ingredients needed to build a successful rare disease nonprofit — and the powerful impact of community-led fundraising.You'll learn:Why deep understanding of CASK gene disorders is essential to progress — including the world's first CASK prevalence study, community-reported symptom data, and strategic scientific collaboration.How Project CASK is building research infrastructure — from mouse models and brain organoids to a biorepository of CASK samples.What cutting-edge therapeutic programs we're funding — including gene replacement therapy, small molecule strategies targeting cerebellum degeneration, and an in-depth epilepsy study.Why education and outreach matter — and how we're equipping families, clinicians, and the public with tools to drive awareness and advocacy.How your participation in Make a Splash for CASK powers every part of this mission — and why every single fundraiser makes a difference.Whether you're a parent, researcher, or advocate, this episode will inspire you to get involved — and give you the roadmap for how community engagement translates into real progress for ultra-rare CASK disorders.Join the Movement:Make a Splash for CASK this August by signing up: givebutter.com/Liocorn/joinLearn more: projectcask.orgFollow us on social: @projectcask

In this episode of Psychobabble, we take a scalpel to the modern autism diagnosis, tracing its dramatic expansion from a severe childhood disorder to a catch-all identity for anxious, rigid adults. Let's examine how psychiatric gatekeeping has failed, how ideology has overtaken evidence, and how terms like "neurodivergent" are used more to shield than to clarify. Not to mention, the ethical costs of this diagnostic inflation. (Navigate to your topic of interest by using the timestamps below.)Upgrade today, become a Psychobabble Insider and join us as we break down what proper treatment should look like for real autism and what it doesn't look like. How therapy supported by the neurodivergent movement plays right into the hands of Cluster B types. We also have a look at the controversial MMR vaccine narrative and its enduring link to autism discourse. Chapter Titles & Timestamps:* 00:00 – The Trauma of Being Autistic* 00:20 – From Disorder to Identity* 01:20 – How the DSM Changed Everything* 04:02 – The Rise of Spectrum Thinking* 07:14 – Self-Diagnosis and the Influence of Pop Culture* 08:12 – Neurodiversity: A Social Movement, Not a Medical One* 10:27 – Sensory Overwhelm or Narcissistic Fragility?* 13:33 – When Inclusion Becomes Exclusion* 14:02 – Autism as a Personal Gospel* 15:59 – Autistic Traits or Personality Quirks?* 18:48 – Autism vs. TikTok* 20:08 – What Real Autism Looks Like* 24:26 – Theories of Autistic Cognition* 27:52 – The Role of Activism in Diagnosis* 30:19 – The Double Empathy Problem Debunked* 33:01 – The Masking Myth* 36:46 – How Cluster B traits reveal themselves* 40:42 – Autism as Status* 44:27 – Who Benefits from Broad Diagnoses?* 46:42 – Why Accurate Diagnosis Matters This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

Episode Highlights With JabanWhat PANS and PANDAS are, and what the key differences areThe different causes of the same neuropsychiatric symptoms and figuring out the underlying issueThere are adult versions of these conditions as wellEarly warning signs of PANS and PANDAS to watch for in children and the autism connectionAutoimmune encephalitis symptoms in kids and why this can be so dramaticWhy this can be a very fast onset and can be triggered by illness 75% of adults in the US have some form of chronic symptomKids have a less developed blood-brain barrier and can experience these symptoms more strongly What recovery from PANS and PANDAS looks like, and what factors to addressWhy not take an extreme treatment approach that overwhelms the bodyWhat his roadmaps for healing look like and the order he follows to best support the bodySupplements that are specifically helpful with things like PANS and PANDASWhen medications are helpful and what else to do alongside themWhen you remove the reasons the body is stressed, it's no longer stressedThe top diet and lifestyle supportive steps to let the body heal he most commonly uses and why he doesn't do long term restrictionResources MentionedDr. Jaban's website, his Instagram, TikTok, and Facebook

Welcome to Awakening Aphrodite — the podcast that helps you reconnect with your feminine energy, reclaim your vitality, and live in harmony with your body, mind, and spirit.In each episode, holistic health expert Amy Fournier shares inspiring conversations with expert guests, blending ancient wisdom and modern science to offer practical tools that help you thrive in today's fast-paced world.Thank you for being part of this beautiful journey. Let's dive in.Featured Guest: Dr. Alexis CowanDr. Cowan is a Princeton-trained molecular biologist, metabolic health expert, and passionate advocate for reconnecting with the rhythms of nature. Her personal health transformation—from childhood illness and significant weight loss to becoming a leader in light biology—will inspire you to rethink your relationship with your environment.Together, we unpack the critical role of sunlight in circadian health, melatonin production, mitochondrial function, and even emotional well-being. We dive into the dangers of blue light and artificial tech exposure, and how geoengineering and modern living environments are disrupting our natural biology.But it's not all theory—Dr. Cowan delivers practical, accessible tools to help you reclaim your natural rhythms, improve your sleep, and optimize your health using the light around you. She also shares her vision for a decentralized light lab, details about her upcoming book, and the profound connection between light, cold exposure, and the electric body.Products Mentioned in This EpisodeMasterPeace: ⁠https://amyfournier.com/masterpeace/ SaunaSpace: https://amyfournier.com/sauna-space/Earthing Grounding Devices: https://amyfournier.com/earthing-2/RaOptics Blue Light Blocking Glasses: https://amyfournier.com/ra-optics/Shop Amy's curated favorite products (with discounts!):

Subscribe in a reader Have you ever wondered if EMDR could really help survivors of narcissistic abuse and trauma bonding? In this video, I talk with Katrina Reese Newton — a trauma expert and EMDR therapist — to break down what EMDR is, how it works, and why it can feel almost like a “magic […] The post EMDR for Narcissistic Abuse: Fast Healing or False Hope? | with Katrina Reese Newton appeared first on Narcissist Abuse Support.

Bipolar disorder is one of the toughest of all mental illnesses. Personal stories about the complexity and severity of bipolar symptoms and behaviors represent great challenges for those fighting for recovery, their friends, family, and many professionals in the psychiatric field. Firsthand accounts provide invaluable information and inspiration when an individual recounts battles and triumphs over bipolar disorder. In this episode, Helen and Valerie interview Patricia Wentzel, a writer and mental health advocate, whose long journey with bipolar disorder ultimately led to a life in recovery—but not before a fierce and powerful struggle lasting many decades. Patricia's amazing story, her strength and determination in the face of this powerful disorder, will educate and inspire listeners everywhere. Find Valerie and Helen at mentalhealthhopeandrecovery.com Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of The Hearing Wellness Journey Podcast, Dr. Dawn Heiman and Dr. Emily Johnson explore Auditory Processing Disorder (APD) — a condition where individuals struggle to understand speech despite normal hearing. Learn how APD affects both children and adults, why traditional hearing tests often miss it, and what specialized evaluations can reveal. They discuss early intervention for students, how adults may finally feel validated after years of unnoticed challenges, and the life-changing benefits of targeted therapies. Whether you're a parent, educator, clinician, or someone personally affected, this episode offers hope, guidance, and real solutions. Topics Covered: • What is APD and how it differs from hearing loss • Why people with normal hearing still struggle to understand speech • Signs of APD in kids and adults • How APD is diagnosed with advanced audiological testing • Real-life success stories and treatment options • The importance of early intervention and advocacy

It's that time of the month (ha), as we take listener questions!  Jason and Jane discuss why the Epstein scandal WILL genuinely hurt Trump with his conspiracy loving base, the complexities of the UK's independent nuclear deterrent, the multilateralism of any new Iran nuclear deal, the implications of blowback from Trump's conspiratorial scaremongering, and if the Russians have the ability to escalate the ongoing conflict in Ukraine or if they are ‘maxed out'.  Plus we handle eloquent verbiage from very verbose mega-orderers' questions: we revisit why neopopulists like Trump are thin skinned and can be hoist on the petards of the own rhetoric, cognitive biases affecting political decision-making, the role of psychology in diplomacy, the future of US-Canada relations and the tragic humanitarian crisis in Gaza. As Jane and Jason Order the Disorder, as always, they end emphasizing the need for innovative win-win solutions to these multifaceted challenges. As always pls write us at Disordershow@gmail.com and pls rate and review the pod giving us 5 stars... Thanks Producer: George McDonagh Subscribe to our Substack for exclusive question from Suzette about the Druze in Syria and the historic resonances of Israel's interventions on behalf of the Druze - https://natoandtheged.substack.com/ Disorder on YouTube - https://www.youtube.com/@DisorderShow  Show Notes Links: Jason on the Epstein Scandal and why it exposes Trump's hypocrisy to his own supporters in ways that his other nefarious actions do not: https://metro.co.uk/2025/07/24/donald-trumps-epstein-files-problem-wont-go-away-will-next-23741815/  Good background on the UK's independent nuclear deterrent - https://www.chathamhouse.org/2025/03/uks-nuclear-deterrent-relies-us-support-there-are-no-other-easy-alternatives  Letter to the Prime Minister calls for the UK to recognise Palestinian statehood - https://una.org.uk/letter-prime-minister-calls-uk-recognise-palestinian-statehood-4  Listen to our episode with Marcel Dirsus: https://pod.link/1706818264/episode/bcd89a117331e217c82af1d018e28d9e  Get Marcel's book at https://www.hachette.co.uk/titles/marcel-dirsus/how-tyrants-fall/9781399809481/  Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome to Awakening Aphrodite — the podcast that helps you reconnect with your feminine energy, reclaim your vitality, and live in harmony with your body, mind, and spirit.In each episode, holistic health expert Amy Fournier shares inspiring conversations with expert guests, blending ancient wisdom and modern science to offer practical tools that help you thrive in today's fast-paced world.Thank you for being part of this beautiful journey. Let's dive in.Featured Guest: Dr. Alexis CowanDr. Cowan is a Princeton-trained molecular biologist, metabolic health expert, and passionate advocate for reconnecting with the rhythms of nature. Her personal health transformation—from childhood illness and significant weight loss to becoming a leader in light biology—will inspire you to rethink your relationship with your environment.Together, we unpack the critical role of sunlight in circadian health, melatonin production, mitochondrial function, and even emotional well-being. We dive into the dangers of blue light and artificial tech exposure, and how geoengineering and modern living environments are disrupting our natural biology.But it's not all theory—Dr. Cowan delivers practical, accessible tools to help you reclaim your natural rhythms, improve your sleep, and optimize your health using the light around you. She also shares her vision for a decentralized light lab, details about her upcoming book, and the profound connection between light, cold exposure, and the electric body.Products Mentioned in This EpisodeMasterPeace: ⁠https://amyfournier.com/masterpeace/ SaunaSpace: https://amyfournier.com/sauna-space/Earthing Grounding Devices: https://amyfournier.com/earthing-2/RaOptics Blue Light Blocking Glasses: https://amyfournier.com/ra-optics/Shop Amy's curated favorite products (with discounts!):

Ryan and Jono are back for another Skate Companion edition of the podcast. Listen along as they watch Disorder Skateboards' new full length video "Distress". Enjoy

Welcome to Awakening Aphrodite — the podcast that helps you reconnect with your feminine energy, reclaim your vitality, and live in harmony with your body, mind, and spirit.In each episode, holistic health expert Amy Fournier shares inspiring conversations with expert guests, blending ancient wisdom and modern science to offer practical tools that help you thrive in today's fast-paced world.Thank you for being part of this beautiful journey. Let's dive in.Featured Guest: Dr. Alexis CowanDr. Cowan is a Princeton-trained molecular biologist, metabolic health expert, and passionate advocate for reconnecting with the rhythms of nature. Her personal health transformation—from childhood illness and significant weight loss to becoming a leader in light biology—will inspire you to rethink your relationship with your environment.Together, we unpack the critical role of sunlight in circadian health, melatonin production, mitochondrial function, and even emotional well-being. We dive into the dangers of blue light and artificial tech exposure, and how geoengineering and modern living environments are disrupting our natural biology.But it's not all theory—Dr. Cowan delivers practical, accessible tools to help you reclaim your natural rhythms, improve your sleep, and optimize your health using the light around you. She also shares her vision for a decentralized light lab, details about her upcoming book, and the profound connection between light, cold exposure, and the electric body.Products Mentioned in This EpisodeMasterPeace: ⁠https://amyfournier.com/masterpeace/ SaunaSpace: https://amyfournier.com/sauna-space/Earthing Grounding Devices: https://amyfournier.com/earthing-2/RaOptics Blue Light Blocking Glasses: https://amyfournier.com/ra-optics/Shop Amy's curated favorite products (with discounts!):

What if the chaos you're facing right now isn't a problem to fix—but an invitation to evolve? In this episode, we dive into the fascinating concept of dissipative structures—a scientific theory that reveals how systems actually need disruption to transform and grow. We explore how this idea plays out in our own lives, from unexpected challenges to relationship breakdowns, and how our perspective can turn disorder into deep personal development. If life feels messy right now, you're not alone—and there may be more meaning in that mess than you think.We'll share stories, science, and spiritual insight as we unpack how growth often requires a bit of chaos. We explore how memory and affirmations can anchor us during uncertainty, why relationships mirror this pattern of transformation, and how recognizing ourselves as “open systems” allows us to adapt, evolve, and expand. If change is the only constant, how can we navigate it with more grace—and even welcome it as part of our soul's evolution? Tune in for a mind-expanding (and heart-opening) perspective on the beauty hidden inside life's most turbulent moments.

Rethinking Oppositional Defiant Disorder—Children Reacting to the System Around Them Curt and Katie chat about Oppositional Defiant Disorder (ODD), reframing it as a response to systemic and environmental stressors rather than a characterological flaw in children. They explore diagnostic challenges, systemic bias, and treatment considerations that support children and families more holistically. This episode is designed to help therapists critically assess and intervene when working with oppositional or defiant behaviors. Course Available for CE Credit:One unit of continuing education is available for this episode at moderntherapistcommunity.com. Listen, purchase the course, pass the post-test, and earn your certificate! Key Takeaways: Understand how ODD criteria can be misapplied without systemic context Identify the impact of trauma, neurodivergence, and racism on misdiagnosis Apply a functional, family systems-based approach to treating oppositional behaviors Learn which interventions are evidence-based—and which to avoid Recognize the importance of treating ODD like an adjustment to environment, not a lifelong label Link to Full Show Notes:Full references, transcript, and resource list at mtsgpodcast.com Join the Modern Therapist Community:Linktree: https://linktr.ee/therapyreimagined Creative Credits: Music by Crystal Grooms Mangano – groomsymusic.com Voice Over by DW McCann – facebook.com/McCannDW

You can be living in a storm and swear it's a sunny day. That's what it's like when insight slips away. In this episode, Dr. Nicole (board certified psychiatrist) and Kit Wallis (lives with schizoaffective disorder) explore why people with serious mental illness, like bipolar disorder, often can't see their own symptoms — even when the evidence is undeniable. Dr. Nicole unpacks the science behind lack of insight and explains how it isn't all-or-nothing. Insight flickers, evolves, and sometimes disappears just when you need it most. From Kit's early experiences hearing voices (and assuming they were just a creative mind) to the manic episodes that shattered her reality, you'll hear firsthand how denial and confusion can coexist. Discover why antipsychotic medications didn't convince Kit the voices weren't real, why manic highs feel too good to question, and why telling someone “you're sick” rarely makes them believe it. If you've questioned why it's so hard to see bipolar symptoms in yourself or a loved one, this conversation will open your eyes to the hidden forces behind denial — and acceptance. Cold Open Transcript: Kit Wallis: It took me years to figure out I was hallucinating. And the voices hated it whenever I did that. They were like, don't do that, don't research us, don't do that. Looking back on it, it doesn't make sense, but in the moment, it made perfect sense to me. It's kind of wild to me that I can go through all this effort to really figure out what is going on and I still have moments where it just completely slips my mind. It still slips my mind when it is happening most of the time. We have a guest host for this episode (Don't worry, Gabe Howard will be back!): Our guest host, Kit Wallis, who goes by SchizoKitzo, is a content creator who advocates for schizoaffective and bipolar disorders. She uses long-form videos on her YouTube channel and short-form content on platforms like TikTok and Instagram. Her content centers around her personal experience with schizoaffective disorder and often includes deep dives into research topics regarding mental health. Kit was diagnosed with the bipolar type of schizoaffective disorder in late 2020 and has struggled with symptoms since she was in middle school. Schizoaffective disorder is a mental health condition where someone experiences symptoms of schizophrenia--such as delusions and hallucinations--but also symptoms of a mood disorder--either major depression or, in Kit's case, bipolar. Realizing there was a lack of schizoaffective advocates, she decided to start her SchizoKitzo project to raise awareness for this complex condition. The mission of SchizoKitzo is to raise awareness of schizoaffective disorder and all of its aspects, from the mood side to the psychotic side. Kit works to bridge the gap between life and science so she can help break the stigma around mental health. Our host, Dr. Nicole Washington, is a native of Baton Rouge, Louisiana, where she attended Southern University and A&M College. After receiving her BS degree, she moved to Tulsa, Oklahoma to enroll in the Oklahoma State University College of Osteopathic Medicine. She completed a residency in psychiatry at the University of Oklahoma in Tulsa. Since completing her residency training, Dr. Nicole has spent most of her career caring for and being an advocate for those who are not typically consumers of mental health services, namely underserved communities, those with severe mental health conditions, and high performing professionals. Through her private practice, podcast, speaking, and writing, she seeks to provide education to decrease the stigma associated with psychiatric conditions. Find out more at DrNicolePsych.com. Learn more about your ad choices. Visit megaphone.fm/adchoices

In today's episode, we're focusing on one of the most critical — and often overlooked — elements of clear aligner therapy: clear aligner attachments. If you've ever dealt with aligners that don't seat, patients who fall behind in treatment, or cases that just aren't progressing as planned, we've got some troubleshooting tips you won't want to miss. Our guest is Dr. Foroud Hakim. He has maintained a private dental practice for over 30 years, is a sought after key opinion leader and speaker and is a highly respected consultant for new product evaluation and development.

Understanding EntropyEntropy is a term from physics, but its truth applies far beyond science. The second law of thermodynamics tells us that in a closed system, entropy—disorder always increases unless energy is put into maintaining or restoring order.Disorder is the natural drift: Why Intention MattersProgress doesn't happen by chance.It requires clarity. Focus. A decision to move forward, even when it's uncomfortable. Your life is not static. You're either building or breaking. Growing or declining.Evolving or eroding.Practical TakeawaysHere are three things you can start doing today to resist entropy:1. Set daily intentions.Don't just let the day happen to you. Decide what matters and move toward it.2. Audit your energy.Are you investing in things that grow you, or just reacting to distractions?3. Maintain your systems.Your habits, your routines, your space—these need your consistent care. Without it, chaos creeps in.

Dan Jones is a retired EPS member (spent time with the gang's unit and homicide team), chair of justice studies, NorQuest College Learn more about your ad choices. Visit megaphone.fm/adchoices

With Michael StephensCheck out our Bookshop.org affiliate site behindthelines and please sign up for my substack at arthursnell.substack.com and/or follow me on Bluesky@snellarthur.bsky.social. You can sometimes find me on other podcasts - most often Disorder which I am involved with in partnership with RUSI, the Royal United Services Institute, the world's oldest think tank. Hosted on Acast. See acast.com/privacy for more information.

What is LFD? How does it apply to me?

In this episode of the Behavioral Observations Podcast, I had the pleasure of speaking with Dr. Brady Phelps, about a topic that has perplexed, and perhaps captivated both mainstream Psychology as well as pop culture: Dissociative Identity Disorder (DID). Our wide-ranging conversation explored the intersection of behavior analysis, mental health, and trauma, with a special focus on how we can understand DID through a scientific, behavioral lens. Brady's Career Journey Brady shared how he discovered behavior analysis almost by accident as an undergrad at Utah State University, under the mentorship of Carl Cheney. After a long academic career, Brady retired in 2021 but remains actively involved in the field. He's currently developing an Experimental Analysis of Behavior (EAB) toolkit with Dr. Steve Eversole at Behavior Development Solutions, and he's also writing a textbook on learning and behavior designed to be accessible to 20-year-olds. Understanding Dissociative Identity Disorder Behaviorally We dove deep into Brady's research on DID, originally published in 2000. His goal was to approach DID from a behavior-analytic perspective, not through traditional psychoanalytic theory. As we discussed, DID has evolved from being characterized by dramatic behavioral shifts to more subtle, self-reported identity disruptions. Brady argued that the identities themselves are better understood as reified constructs—products of distorted tacting that contacts reinforcement—rather than discrete psychological entities. Trauma, Dissociation, and Behavioral Function Brady emphasized the importance of not dismissing trauma reports, while also cautioning against assuming trauma automatically leads to DID. We talked about avoidance behaviors, escape contingencies, and how dissociation might function as a response to overwhelming experiences. He brought up examples like Cotard's Syndrome to show how distorted tacting can manifest in extreme ways. Rethinking Diagnostic Criteria for DID We discussed research into amnesiac barriers, such as the Concealed Information Test, which shows people might learn something even if they claim not to remember it. These findings, Brady suggested, should prompt a re-evaluation of how DID is diagnosed, particularly the differences between the Post-Trauma Model and the Social-Cognitive Model—the latter of which emphasizes social reinforcement and therapist influence in shaping alternate identities. Therapy Techniques and Reinforcement Contingencies Brady detailed how some therapists use techniques like “roll calls” or even suggesting names to clients in session. While these methods may sound extreme, they reflect how therapist behavior can inadvertently reinforce identity fragmentation. We also discussed Robert Kohlenberg's 1973 study on behavioral repertoires, which demonstrated how social reinforcement shaped client behavior across different identity presentations. The Sybil Case and Media Influence We revisited the infamous Sybil case, which helped popularize DID in the 20th century. Despite being exposed as fraudulent, Sybil's story continues to shape public and clinical views of the disorder. We also talked about more recent media portrayals—from TikTok to a 2023 Scientific American article—and how social media can reinforce the performance of alternate identities, especially among vulnerable populations. Behavior Analysis in Mental Health Brady and I wrapped up with a discussion on how behavior analysts can contribute to mental health conversations. He encouraged new BCBAs to collaborate with non-behavioral colleagues while staying rooted in behavioral principles. Above all, he emphasized balancing empathy with scientific rigor—understanding people without falling into speculative mentalism. Show Notes and Resources Brady (2025). Dissociative Identity Disorder: An Analysis of the Behaviors and Contingencies Brady (2000). Dissociative Identity Disorder: The Relevance of Behavior Analysis Kohlenberg (1973). Behavioristic approach to multiple personality: A case study Wakatama (2024). Court allows witness with dissociative identity disorder to give evidence in multiple personalities Explore the EAB Toolkit at Behavior Development Solutions Lester (2023). A New Therapy for Multiple Personality Disorder Helps a Woman with 12 Selves Who was Sybil? The true story behind her multiple personalities  

With the increase in the public's attention to all aspects of brain health, neurologists need to understand their role in raising awareness, advocating for preventive strategies, and promoting brain health for all. To achieve brain health equity, neurologists must integrate culturally sensitive care approaches, develop adapted assessment tools, improve professional and public educational materials, and continually innovate interventions to meet the diverse needs of our communities. In this BONUS episode, Casey Albin, MD, speaks with Daniel José Correa, MD, MSc, FAAN and Rana R. Said, MD, FAAN, coauthors of the article “Bridging the Gap Between Brain Health Guidelines and Real-world Implementation” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Correa is the associate dean for community engagement and outreach and an associate professor of neurology at the Albert Einstein College of Medicine Division of Clinical Neurophysiology in the Saul Korey Department of Neurology at the Montefiore Medical Center, New York, New York. Dr. Said is a professor of pediatrics and neurology, the director of education, and an associate clinical chief in the division of pediatric neurology at the University of Texas Southwest Medical Center in Dallas, Texas. Additional Resources Read the article: Bridging the Gap Between Brain Health Guidelines and Real-world Implementation Subscribe to Continuum®: shop.lww.com/Continuum Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Guests: @NeuroDrCorrea, @RanaSaidMD Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. This exclusive Continuum Audio interview is available only to you, our subscribers. We hope you enjoy it. Thank you for listening. Dr Albin: Hi all, this is Dr Casey Albin. Today I'm interviewing Dr Daniel Correa and Dr Rana Said about their article on bridging the gap between brain health guidelines and real-world implementation, which they wrote with Dr Justin Jordan. This article appears in the June 2025 Continuum issue on disorders of CSF dynamics. Thank you both so much for joining us. I'd love to just start by having you guys introduce yourselves to our listeners. Rana, do you mind going first? Dr Said: Yeah, sure. Thanks, Casey. So, my name is Rana Said. I'm a professor of pediatrics and neurology at the University of Texas Southwestern Medical Center in Dallas. Most of my practice is pediatric epilepsy. I'm also the associate clinical chief and the director of education for our division. And in my newer role, I am the vice chair of the Brain Health Committee for the American Academy of Neurology. Dr Albin: Absolutely. So just the right person to talk about this. And Daniel, some of our listeners may know you already from the Brain and Life podcast, but please introduce yourself again. Dr Correa: Thank you so much, Casey for including us and then highlighting this article. So yes, as you said, I'm the editor and the cohost for the Brain and Life podcast. I do also work with Rana and all the great members of the Brain Health Initiative and committee within the AAN, but in my day-to-day at my institution, I'm an associate professor of neurology at the Albert Einstein College of Medicine in the Montefiore Health System. I do a mix of general neurology and epilepsy and with a portion of my time, I also work as an associate Dean at the Albert Einstein College of Medicine, supporting students and trainees with community engagement and outreach activities. Dr Albin: Excellent. Thank you guys both so much for taking the time to be here. You know, brain health has really become this core mission of the AAN. Many listeners probably know that it's actually even part of the AAN's mission statement, which is to enhance member career fulfillment and promote brain health for all. And I think a lot of us have this kind of, like, vague idea about what brain health is, but I'd love to just start by having a shared mental model. So, Rana, can you tell us what do you mean when you talk about brain health? Dr Said: Yeah, thanks for asking that question. And, you know, even as a group, we really took quite a while to solidify, like, what does that even mean? Really, the concept is that we're shifting from a disease-focused model, which we see whatever disorder comes in our doors, to a preventative approach, recognizing that there's a tremendous interconnectedness between our physical health, our mental health, cognitive and social health, you know, maintaining our optimal brain function. And another very important part of this is that it's across the entire lifespan. So hopefully that sort of solidifies how we are thinking about brain health. Dr Albin: Right. Daniel, anything else to add to that? Dr Correa: One thing I've really liked about this, you know, the evolution of the 2023 definition from the AAN is its highlight on it being a continuous state. We're not only just talking about prevention of injury and a neurologic condition, but then really optimizing our own health and our ability to engage in our communities afterwards, and that there's always an opportunity for improvement of our brain health. Dr Albin: I love that. And I really felt like in this article, you walked us through some tangible pillars that support the development and maintenance of this lifelong process of maintaining and developing brain health. And so, Daniel, I was wondering, you know, we could take probably the entire time just to talk about the five pillars that support brain health. But can you give us a pretty brief overview of what those are that you outlined in this article? Dr Correa: I mean, this was one of the biggest challenges and really bundling all the possibilities and the evidence that's out there and just getting a sense of practical movement forward. So, there are many organizations and groups out there that have formed pillars, whether we're calling them seven or eight, you know, the exact number can vary, but just to have something to stand on and move forward. We've bundled one of them as physical and sleep health. So really encouraging towards levels of activity and not taking it as, oh, that there's a set- you know, there are recommendations out there for amount of activity, but really looking at, can we challenge people to just start growing and moving forward at their current ability? Can we challenge people to look at their sleep health, see if there's an aspect to improve, and then reassess with time? We particularly highlight the importance of mental health, whether it's before a neurologic condition or a brain injury occurs or addressing the mental health comorbidities that may come along with neurologic conditions. Then there's of course the thing that everyone thinks about, I think, with brain health in terms of is cognitive health. And you know, I think that's the first place that really enters either our own minds or as we are observers of our elder individuals in our family. And more and more there has been the highlight on the need for social interconnectedness, community purpose. And this is what we include as a pillar of social health. And then across all types of neurologic potential injuries is really focusing on the area of brain injury. And so, I think the area that we've often been focused as neurologists, but also thinking of both the prevention along with the management of the condition or the injury after it occurs. Dr Albin: Rana, anything else to add to that? That's a fantastic overview. Dr Said: Daniel, thank you for- I mean, you just set it up so beautifully. I think the other thing that maybe would be important for people to understand is that as we're talking through a lot of these, these are individual. These sound like very individual-basis factors. But as part of the full conversation, we also have to understand that there are some factors that are not based on the individual, and then that leads to some of the other initiatives that we'll be talking about at the community and policy levels. So, for example, if an individual is living in an area with high air pollution. Yes, we want them to be healthy and exercise and sleep, but how do we modify those factors? What about lead leaching from our aging pipes or even infectious diseases? So, I think that outside of our pillars, this is sort of the next step is to understand what is also at large in our communities. Dr Albin: That's a really awesome point. I love that the article really does shine through and that there are these individual factors, and then there there's social factors, there's policy factors. I want to start just with that individual because I think so many of our patients probably know, like, stress management, exercise, sleep, all of that stuff is really important. But when I was reading your article, what was not so obvious to me was, what's the role that we as neurologists should play in advocating? And really more importantly, like, how should we do that? And again, it struck me that there are these kind of two issues at play. And one is that what Daniel was saying that, you know, a lot of our patients are coming because they have a problem, right? We are used to operating in this disease-based care, and there's just limited time, competing clinical demands. If they're not coming to talk about prevention, how do we bring that in? And so Rana, maybe I'll start with you just for that question, you know, for the patients who are seeing us with a disease complaint or they're coming for the management of a problem, how are you organizing this at the bedside to kind of factor in a little bit about that preventative brain health? Dr Said: You know, I think the most important thing at the bedside is, one, really identifying the modifiable risk factors. These have been well studied, we understand them. Hypertension, diabetes, smoking, weight management. And we know that these definitely are correlative. So is it our role just to talk about stroke, or should we talk about, how are you managing your blood pressure? Health education, if there was one major cornerstone, is elevating health literacy for everyone and understanding that patients value clear and concise information about brain health, about modifiable risk factors. And the corollary to that, of course, are what are the resources and services? I completely understand---I'm a practicing clinician---the constraints that we have at the bedside, be it in the hospital or in our clinics. And so being the source of information, how are we referring our families and individuals to social workers, community health worker support, and really partnering with them, food banks, injury prevention programs, patient advocacy organizations? I think those are really ways that we can meet the impacts that we're looking at the bedside that can feel very tangible and practical. Dr Albin: That's really excellent advice. And so, I'd like to ask a follow-up question. With your knowledge of this, trying to get more multidisciplinary buy-in from your clinic so that you really have the support to get these services that are so critically important. And how do you do that? Dr Said: Yeah, I think it's, one, being a champion. So, what does a champion mean? It means that somebody has to decide this is really important. And I think we all realize that we're not the only ones in the room who care about this. We're all in this, and we all care about it. But how do we champion it and carry it through? And so that's the first. Second you find your partnerships: your social workers, your case managers, your other colleagues. And then what is the first-level entry thing that you can do? So for example, I'm a pediatric epileptologist. One of the things we know is that in pediatric epilepsy, depression and anxiety are very strong comorbidities. So, before we get to the point where a child is in distress, every single one of our epilepsy patients who walks in the door over the age of twelve has an age-appropriate screener that is given to them in both English and Spanish. And we assess it and we determine stratifying risk. And then we have our social workers on the back end and we decide, is this a child who needs resources? Is this a child who needs to be walked to the emergency room, escorted? And anything in between. And I think that that was a just a very tangible example of, every single person can do this and ask about it. And through the development of dot phrases and clear protocols, it works really well. Dr Albin: I love that, the way that you're just being mindful. At every step of the way, we can help people towards this lifelong brain health. And Daniel, you work with an adult population. So I wonder, what are your tips for bringing this to a different patient population? Dr Correa: Well, I think---adult or child---one thing that we often are aware of with so many of the other things that we're doing in bedside or clinic room counseling, but we don't necessarily think of in this context of brain health, is, remember all the people in the room. So, at the bedside, whether it's in the ICU, discharge counseling, the initial admission, the whole family is often involved and really concerned about the active issue. But you can look for opportunities- we often try to counsel and support families about the importance of their own sleep and rest and highlighting it not just as being there for their family member, but highlighting it to them as a measure of their own improvement of their brain health. So, looking at ways where, one, I try to find, is there something I can do to support and educate the whole family about their brain health? And then- and with an epilepsy, or in many other situations, I try to look for one comorbidity that might be a pillar of brain health to address that maybe I wasn't already thinking. And then I consider, is there an additional thing that they wouldn't naturally connect to their epilepsy or their headaches that I can bring in for them to work on? You know, we can't often give people twelve different things to work on, and they'd just feel like, okay like, you have no realistic understanding of my life. But if we can just highlight on one, and remind them that there can be many more ways to improve their health and to follow up either with us as their neurologist or their future primary care doctors to address those additional needs. Again, I would really highlight the importance of a multidisciplinary approach and looking for opportunities. We've too often, I feel, relied on primary care as being the first line for addressing unmet social health needs. We know that so many people, once they have a neurologic condition or the potential, even, of a neurologic condition, they're concerned about dementia or something, they may view us, as their neurologist, as their most important provider. And if they don't have the resource of time and money to show up at other doctors, we may be the first one they're coming to. And so, tapping into your institution's resources and finding out, are there things that are available to the primary care services that for some reason we're not able to get on the inpatient side or the outpatient side? Referring to social workers and care workers and showing that our patients have an independent need, that they're not somehow getting captured by the primary care doctors. Dr Albin: I really love that. I think that we- just being more invested and just being ready to step into that role is really important. I was noticing in this article, you really call that being a brain health ambassador, being really mindful, and I will direct all of our listeners to Figure 3, which really captures what practitioners can do both at the bedside, within their local community, and even at the professional society level, to really advocate for policies that promote brain wellness. Rana, at the very beginning of this conversation, you noted, you know, this is not just an individual problem. This really is something that is a component of our policy and the structure of our local communities. I really loved in the article, there's a humility that this cannot be just a person-by-person bedside approach, that this is a little bit determined by the social determinants of health. And so, Rana, can you walk us through a little bit of what are the social determinants of health, and why are these so crucially important when we think about brain health for all? Dr Said: Yeah, social determinants of health are a really key factor that it looks at, what are the health factors that are environmental; for example, that are not directly like what your blood pressure is, what, you know, what your BMI is, that definitely impact our health outcomes. So, these include environmental things like where people are born, where they live, where they learn, work, play, worship, and age. It encompasses factors like your socioeconomic status, your education, the neighborhoods where you are living, definitely healthcare access. And then all of this is in a social and community context. We know that the impact of social determinants of health on brain health are profound for the entire lifespan and that- so, for example, if someone is from a disadvantaged background or that leads to chronic stress, they can have limited access to healthcare. They can have greater risk of exposure to, let's say, environmental toxins, and all of that will shape how their brain health is. Violence, for example. And so, as we think about how we're going to target and enhance brain health, we really have to understand that these are vulnerable populations, special high-risk populations, that often have a disproportionate burden of neurologic disorders. And by identifying them and then developing targeted interventions, it promotes health equity. And it really has to be done in looking at culturally- ethnocultural-sensitive healthcare education resources, thinking about culturally sensitive or adaptive assessment tools that work for different populations so that these guidelines that we have, that we've already identified as being so valuable, can be equitably applied, which is one crucial component of reducing brain health risk factors. And lastly, at the neighborhood level, this is where we really rely on our partnerships with community partners who really understand their constituents and they understand how to have the special conversations, how to enhance brain health through resource utilization. And so, this is another plug for policy and resources. Dr Albin: I love that. And thinking about the neighborhood and the policy levels and all the things that we have to do. Daniel, I'd like to ask you, is there anything else you would add? Dr Correa: Yeah, you know, so I really wanted to come back to this thing is that often and unfortunately, in the beginning understanding of social determinants of health, they're thought of as a positive or a negative factor, and often really negative. These are just facts. They're aspects about our community, our society, and some of them may be at the individual level. They're not at fault of any individual or community, or even our society. They're just the realities. And when someone has a factor that may predict a health disparity or an unmet social need---I wanted to come back to that concept and that term---one or two positive factors that are social determinants of health for that individual are unmet social needs. It's a point of promise. It's a potential to be addressed. And seeking ways to connect them with community services, social work, caregivers, these are ways where- that we can remove a barrier to, so that the possibility of the recommendations that we're used to doing, giving recommendations about medications and management, can be fully appreciated for that person. And the other aspect is, like brain health, this is a continuous state. The social determinants of health may be different for the child, the parent, and the elderly family member in the household, and there might be some that are shared across them. And when one of those individuals has a new medical illness or a new condition, a stroke, and now has a mobility limitation, that may change a social determinant of health for that person or for anyone else in the family, the other people now becoming caregivers. We're used to this. And for someone after a stroke or traumatic brain injury, now they have mobility changes. And so, we work on addressing those. But thinking on how those things now become a barrier for engaging with community and accessing things, something as simple as their pharmacy. Dr Albin: I hear a lot of “this is a fluid situation,” but there's hope here because these are places that we can intervene and that we can really champion brain health throughout this fluid situation. Which kind of brings me to what we're going to close out with, which is, I'm going to have you do a little thought exercise, which is that you find a magic lamp and a genie comes out. And we'll call this the brain health genie. The genie says that they are going to grant you one wish for the betterment of brain health. Daniel, I'll start with you. What is the one thing that you think could really move the needle on promoting and maintaining brain health? Dr Correa: I will jump on nutrition and food access. If we could somehow get rid of food insecurity and have access to whole and fresh foods for everyone, and people could go back to looking at opportunities from their ancestral and cultural experiences to cook and make whole-food recipes from their own cultures. Using something like the Mediterranean diet and the mind diet as a framework, but not looking at those as cultural barriers that we somehow all have to eat a certain way. So, I think that would really be the place I would go to first that would improve all of our brain health. Dr Albin: I love that. So, wholesome eating. Rana, how about you? One magic wish. Dr Said: I think traumatic brain injury prevention. I think it's so- it feels so within our reach, and it just always is so heart-hurting when you think that wearing helmets, using seatbelts, practicing safety in sports, gun safety---because we know unfortunately that in pediatric patients, firearm injury is the leading cause of traumatic brain injury. In our older patients, fall reduction. If we could figure out how to really disseminate the need for preventative measures, get everyone really on board, I think this is- the genie wouldn't have to work too hard to make that one come true. Dr Albin: I love that. As a neurointensivist, I definitely feel that TBI prevention. We could talk about this all day long. I really wish we had a longer bit of time, but I really would direct all of our listeners to this fantastic article where you give really practical advice. And so again, today I've been interviewing Drs Daniel Correa and Rana Said about their article on bridging the gap between brain health guidelines and real-world implementation, written with Dr Justin Jordan. This article appears in the most recent issue of Continuum on the disorders of CSF dynamics. Be sure to check out Continuum Audio episodes from this and other issues. And thank you so much for our listeners for joining us today. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. We hope you've enjoyed this subscriber-exclusive interview. Thank you for listening.

Few social issues have proven quite as controversial or emotional as the fraught subject of gender dysphoria treatment for minors. In both the UK and US, the question has vexed doctors, lawyers and politicians. The balance between the medical and psychological wellbeing of trans youngsters presents unique challenges for physicians and legislators, and it feels like we are yet to alight upon a compassionate solution. To discuss, the Law & Disorder team are joined by two great experts from either side of the pond. David D. Cole is a top US constitutional lawyer and former National Legal Director of the ACLU, who has brought challenges to the absolutist position of American state legislators; Hilary Cass is a retired paediatrician and author of the Cass Review into gender care in England, who now sits alongside Charlie and Helena in the House of Lords. In this discussion, they probe the position of both courts and the medical services, in the hope that clarity might be found in such a challenging issue.If you have questions, criticisms, praise or other feedback, please do send your thoughts to us via lawanddisorderfeedback@gmail.com!Law and Disorder is a Podot podcast.Hosted by: Charlie Falconer, Helena Kennedy, Nicholas Mostyn.Executive Producer and Editor: Nick Hilton.Associate Producer: Ewan Cameron.Music by Richard Strauss, arranged and performed by Anthony Willis & Brett Bailey. Hosted on Acast. See acast.com/privacy for more information.

Come to a Dehoarding Accountability Zoom Session: http://www.overcomecompulsivehoarding.co.uk/ticket Subscribe to the podcast: https://www.overcomecompulsivehoarding.co.uk/subscribe Podcast show notes, links and transcript: http://www.overcomecompulsivehoarding.co.uk/  Why is it so hard to deal with uncertainty, and what does that have to do with hoarding? This week I'm joined by Dr Jan Eppingstall to unpack how our brains handle ambiguity, why fear of making mistakes can keep us stuck, and how intolerance of uncertainty feeds into hoarding behaviours. We break down practical ways to build up your tolerance for not knowing and share some strategies that might actually make a difference. Uncertainty and Its Challenges Definition and context of uncertainty Evolutionary reasons for discomfort with uncertainty (Selfish Brain Theory) Contrast between historical resource scarcity and modern abundance Our minds' outdated ways of managing uncertainty Cognitive Closure What is cognitive closure? Difference between cognitive closure (psychological need for definite answers) and “closure” in pop culture (emotional resolution) How it relates to need for certainty in present/future, not just past events The creation of cognitive closure measurement scales by researchers Factors influencing need for cognitive closure: Personality traits: Conscientiousness, neuroticism (now called emotionality), openness to experience, extroversion Trauma history and its effects on the nervous system Neurodivergence (with emphasis on autism and “sticky thinking”) Combination of personality, trauma, and neurodivergence Intolerance of Uncertainty Psychological definition of intolerance of uncertainty Negative cognitive bias: How it affects perception and response Manifestations in people experiencing uncertainty as distress Its direct relevance to hoarding behaviours The Link Between Hoarding Disorder and Intolerance of Uncertainty Research findings: intolerance of uncertainty as a predictor of hoarding symptom severity Usefulness in early intervention strategies intolerance of uncertainty as a transdiagnostic factor (across anxiety, some depression, and other mental health conditions) How heightened anxiety sensitivity in hoarding perpetuates avoidance Experiential avoidance in hoarding (saving and acquiring behaviours) Connection between maladaptive behaviours and intolerance of uncertainty Fear of Making Mistakes and Perfectionism Common fears of mistakes in hoarding (disposing, acquiring, putting things away) Perfectionism's role (fear of failure, not wasting) All-or-nothing thinking and rigid decision-making rules Paralysing effect of avoidance due to fear of mistakes Not making a decision as a potential mistake itself Interaction and reinforcement between perfectionism and intolerance of uncertainty Comorbidity and Severity Research on multiple diagnoses: More than half of psychiatric patients have more than one diagnosis Diagnostic challenges and overlapping criteria How comorbidity compounds issues: More symptoms and more complexity Higher intolerance of uncertainty linked with more severe hoarding, especially when other conditions are present Impact on treatment difficulty intolerance of uncertainty's Impact on Acquiring and Discarding Behaviours How acquiring reduces fear of missing out and future needs Difficulty discarding as protection against future regret Shame around mistake-making Common inner questions: Future use, responsibility, relationships More complexity leading to more avoidance Nuances in intolerance of uncertainty and Hoarding Study on sub-factors of uncertainty: Factor 1: Negative self-referential implications (linked to hoarding severity) Factor 2: Perception of uncertainty as unfair (not linked) Internal vs. external perspectives on uncertainty Relevance of anxiety-driven self-criticism Changing Relationship to Uncertainty: Curiosity and Reframing Rilke's quote on “loving the questions” Transforming approach from fear to curiosity Curiosity as a therapeutic tool Creativity in imagining alternatives and solutions Relevance of loss aversion and cognitive biases Modern Life and Uncertainty Intolerance Research linking increased use of technology (instant answers) to rising intolerance of uncertainty Smartphone/information overload and decreased tolerance “muscle” Relevance to hoarding (desire for backups, information saving) Example: IMDb, screenshots, saving digital info Treatment Strategies Cognitive Behavioural Therapy (CBT) effects on intolerance of uncertainty in anxiety Acceptance and Commitment Therapy (ACT) and exposure-based methods: Pros and cons Importance of a therapist experienced in error-related distress and uncertainty Key skills: Observing distress, sitting with uncomfortable feelings, gradual exposure Self-help approaches: Reframing mistakes as learning Practicing self-compassion Values-based decision-making Systematic exposure to small errors Gradually breaking rigid rules (e.g., waste, tidiness) Recognising individual differences and seeking appropriate support Embracing Mistakes and Humanity Learning from therapist/client anecdotes Cultural expectations around perfectionism vs. real human messiness How mistakes can be positive or even entertaining Letting go of the need for perfection The Four Cs for Managing Uncertainty From Elizabeth Weingarten: Curiosity, Conversation, Community, Commitment How to foster each: Curiosity: Approach with questions and exploration Conversation: Discuss uncertainties with trusted people Community: Build social support Commitment: Dedication to exploring questions and knowing when to let go Links Hillman, S. R. HOARDING DISORDER AND Intolerance of Uncertainty, Anxiety Sensitivity and Distress Tolerance in Hoarding Disorder Compared to OCD and Healthy Controls - Shemariah R. Hillman; Claire L. Lomax; Nadeen Khaleel; Theresa R. Smith; James D. Gregory Baldwin, P. A Multimethod Examination of Vulnerability in Hoarding, UNSW Sydney, 2016. https://doi.org/10.26190/UNSWORKS/19156 Castriotta, N.; Dozier, M. E.; Taylor, C. T.; Mayes, T.; Ayers, C. R. Intolerance of Uncertainty in Hoarding Disorder. Journal of Obsessive-Compulsive and Related Disorders 2019, 21, 97–101. https://doi.org/10.1016/j.jocrd.2018.11.005 Exploring Humanity's Relationship to Uncertainty with Elizabeth Weingarten  Podcast ep 49: Sitting with discomfort: distress tolerance and hoarding – How unconscious distress avoidance might be worsening your problems Podcast ep 190: What if we forgive ourselves, but now we know better, we do better? Choosing compassion over shame in hoarding disorder Podcast ep 182: What are “towards and away moves” and what on earth do they have to do with hoarding recovery? With Dr Jan Eppingstall Podcast ep 127: Overcoming overspending with Paige Pritchard, Money Coach Come to a Dehoarding Accountability Zoom session: Accountability Booking Form Dr Jan Eppingstall at Stuffology https://www.facebook.com/stuffologyconsulting/ https://twitter.com/stuff_ology https://www.instagram.com/stuff_ology/ Dr Jan Eppingstall on Pinterest Website: Overcome Compulsive Hoarding Become a Dehoarding Darling Submit a topic for the podcast to cover Questions to ask when dehoarding: https://www.overcomecompulsivehoarding.co.uk/podquestions Instagram: @thathoarderpodcast Twitter: @ThatHoarder Mastodon: @ThatHoarder@mastodon.online TikTok: @thathoarderpodcast Facebook: Overcome Compulsive Hoarding with That Hoarder Pinterest: That Hoarder YouTube: Overcome Compulsive Hoarding with That Hoarder Reddit: Overcome Compulsive Hoarding with That Hoarder subreddit Help out: Support this project Sponsor the podcast Subscribe to the podcast Subscribe to the podcast here

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We're honored to welcome back Dr. Claire Wilcox, a trailblazer in the field of food addiction. Claire is an addiction psychiatrist, former internist, and associate professor of translational neuroscience at the Mind Research Network. She's worked in everything from eating disorder treatment centers to general psychiatry and is on the frontlines of research, clinical care, and advocacy. Her academic textbook Food Addiction, Obesity and Disorders of Overeating has helped shape the professional dialogue—but today, we're talking about her newest book, Rewire Your Food-Addicted Brain: Fight Cravings and Break Free from a High-Sugar, Ultra-Processed Diet—a compassionate, research-informed, and accessible guide for individuals navigating food addiction. And here's the wild part: this book was directly inspired by the Food Junkies Podcast.

Recorded 2025-07-24 03:01:46

In this eye-opening episode, Monika Ostroff, LICSW, CEDS-S (she/they), a renowned expert in the eating disorder field, courageously shares her lived experience with Dissociative Identity Disorder (DID) and Anorexia Nervosa (AN). With over 25 years of professional experience, Monika gives us an intimate look at the complexities of living with DID, explains how it complicates eating disorder recovery, and provides critical insights for mental health providers. Whether you're a clinician, someone in recovery, or simply looking to better understand DID and eating disorders, this conversation offers profound, compassionate wisdom that's often missing from mainstream discussions.   If you enjoy our show, please rate, review, subscribe, and tell your friends and colleagues!   Interested in being a guest on All Bodies. All Foods.? Email podcast@renfrewcenter.com for a chance to be featured.   All Bodies. All Foods. is a podcast by The Renfrew Center. Visit us at: https://renfrewcenter.com/

We've heard about Putin bluffing. Abraham Lincoln was an accomplished poker player and Churchill dabbled at chess. But to our mind it is Backgammon that best reflects both politics and life decisions. It's a game of skill, luck, reversals and socializing. So could world leaders use Backgammon to help them develop their empathy, strategic thinking, resilience, and make better decisions? In this conversation, Jason Pack is joined by Marc Olsen – fellow Backgammon Grandmaster, former professional footballer, and the CEO and Founder of Backgammon Galaxy. Together they explore the multifaceted world of Backgammon. They unpack how it is a metaphor for life, decision-making, and the balance between order and disorder.  They discuss Marc's journey from professional football to becoming the CEO of Backgammon Galaxy, the conformism of Scandinavian society, and how a rebellious nature led Marc to discover Austrian school economics. Plus: the emotional aspects of learning through games, the relevance of game theory in the Enduring Disorder, and the unique features of Backgammon that make it a rich learning experience. And as they Order they Disorder – how Backgammon can foster empathy and social skills, and the potential of Backgammon as a tool for cross-cultural connection, especially in the Middle Eastern region. Producer: George McDonagh Subscribe to our Substack - https://natoandtheged.substack.com/ Disorder on YouTube - https://www.youtube.com/@DisorderShow  Show Notes Links: For more on Backgammon Galaxy visit - https://www.backgammongalaxy.com/  To watch the 2024 World Backgammon Championship Final commentated by Marc: https://www.youtube.com/watch?v=6d7-ky1bROk  For a very fun video produced by Marc and featuring Jason about the World Backgammon Championship: https://www.youtube.com/watch?v=TebkgCNS7OI  For Marc on the Gentleman Scofflaw podcast - https://podcasts.apple.com/gb/podcast/the-gentleman-scofflaw-podcast/id1216891117?i=1000650103880  Learn more about your ad choices. Visit megaphone.fm/adchoices

Childhood-onset hydrocephalus encompasses a wide range of disorders with varying clinical implications. There are numerous causes of symptomatic hydrocephalus in neonates, infants, and children, and each predicts the typical clinical course across the lifespan. Etiology and age of onset impact the lifelong management of individuals living with childhood-onset hydrocephalus. In this episode, Casey Albin, MD, speaks with Shenandoah Robinson, MD, FAANS, FAAP, FACS, author of the article “Childhood-onset Hydrocephalus” in the Continuum® June 2025 Disorders of CSF Dynamics issue. Dr. Albin is a Continuum® Audio interviewer, associate editor of media engagement, and an assistant professor of neurology and neurosurgery at Emory University School of Medicine in Atlanta, Georgia. Dr. Robinson is a professor of neurosurgery, neurology, and pediatrics at Johns Hopkins University School of Medicine in Baltimore, Maryland. Additional Resources Read the article: Childhood-onset Hydrocephalus Subscribe to Continuum®: shop.lww.com/Continuum Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Host: @caseyalbin Full episode transcript available here Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum. Thank you for listening to Continuum Audio. Be sure to visit the links in the episode notes for information about earning CME, subscribing to the journal, and exclusive access to interviews not featured on the podcast. Dr Albin: Hi, this is Dr Casey Albin. Today I'm interviewing Dr Shenandoah Robinson about her article on childhood onset hydrocephalus, which appears in the June 2025 Continuum issue on disorders of CSF dynamics. Dr Robinson, thank you so much for being here. Welcome to the podcast. I'd love to start by just having you briefly introduce yourself to our audience. Dr Robinson: I'm a pediatric neurosurgeon at Johns Hopkins, and I'm very fortunate to care for kids and children from the neonatal intensive care unit all the way up through young adulthood. And I have a strong interest in developing better treatments for hydrocephalus. Dr Albin: Absolutely. And this was a great article because I really do think that understanding how children with hydrocephalus are treated really does inform how we can care for them throughout the continuum of their lifespan. You know, I was shocked in reading your article about the scope of the problem for childhood onset hydrocephalus. Can you walk our listeners through what are the most common reasons why CSF diversion is needed in the pediatric population? Dr Robinson: For the United States, and Canada too, the most common reasons are spina bifida---so, a baby that's born with a myelomeningocele and then develops associated hydrocephalus---and then about equally as common is posthemorrhagic hydrocephalus of prematurity, congenital causes such as from aquaductal stenosis, and other genetic causes are less common. And then we also have kids that develop hydrocephalus after trauma or meningitis or tumors or other sort of acquired problems during childhood. Dr Albin: So, it's a really diverse and sort of heterogeneous causes that across sort of the, you know, the neonatal period all the way to, you know, young adulthood. And I'm sure that those etiologies really shift based on sort of the subgroup population that you're talking about. Dr Robinson: Yes, they definitely shift over time. Fortunately for our kids that are born with problems that raise concerns, such as myelomeningocele or if they're born preterm, they sort of declare themselves by the time they're a year old. So, if you're an adult provider, they should have defined themselves and it's unlikely that they will suddenly develop hydrocephalus as a teenager or older adult. Dr Albin: Totally makes sense. I think many of the listeners to this podcast are adult neurologists who are probably very familiar with external ventriculostomies for temporary CSF diversion, and with the more permanent ventricular peritoneal shines or ventricular atrial or plural shines that are needed when there's the need for permanent diversion. But you described in your article two procedures that provide temporary CSF diversion that I think many of our listeners are probably not as familiar with, which is the ventricular access devices and ventriculosubgaleal shunts. Can you briefly describe what those procedures provide? Who are the candidates for them? And then what complications neurologists may need to think about if they're consulted for comanagement in one of these complex patients? Dr Robinson: Well, the good thing is that if as an adult neurologist you encounter someone with, you know, residual tubing from one of these procedures, you are unlikely to need to do anything about it. So, we put in ventricular access device or ventriculosubgaleal shunts, usually in newborns or infants. And sometimes when they no longer need the device, we just leave it in because that saves them an extra surgery. So, if you encounter one later on, it's most likely you won't need to do anything. Often if the baby goes on to show that they need a permanent shunt, we go ahead and put in that permanent shunt. We may or may not go back and take out the reservoir or the subgaleal shunt. The reservoir and subgaleal shunts are often put in the frontal location. Sometimes we'll put the permanent shunt in the occipital location and just leave the residual tubing there. So, you're very unlikely to need to intervene with a reservoir or subgaleal shunt if you encounter an older child or adult with that left in. We use these in the small babies because the external ventricular drains that we're very familiar with have a very high complication rate in this population. In the adult ICU, you often see these, and maybe there's, you know, a few percent risk of infection. It actually heads into 20 to 25% in our preterm infants and other newborns that require one of these devices for drainage. So, we try not to use external ventricular drains like we use in older patients. We use the internalized device: either the ventricular reservoir with a little area for us to tap every day, every other day; or the ventriculosubgaleal shunt, which diverts the spinal fluid to a pocket in the scalp. So, we use these in preterm infants that are too tiny for a permanent shunt. And for some of our babies that are born, for example, with an omphalocele, that we can't use their peritoneal cavity and so we need some temporizing device to manage their CSF. Dr Albin: Totally makes sense. And so just to clarify, I mean, this is a tube that's placed into the ventricles of the brain and then it's tunneled into the subgaleal space and the collection, the CSF, just builds up there, like? Dr Robinson: Yeah. Dr Albin: And over time either, you know, the baby will learn how to account for that extra CSF, and then I guess it's just reabsorbed? Dr Robinson: Yeah. When it's present, though, it looks like maybe, I don't know if you're familiar with like a tissue expander. There is this bubble of fluid under the scalp, but it's prominent, it can be several centimeters in diameter. Dr Albin: Wow, that's just absolutely fascinating. And I don't think I've ever had the opportunity to see this in clinical practice. I've really learned quite a bit about this. I assume that these children are going to go on to get some sort of permanent diversion. And then, you know, over time, those permanent shunts do create a lot of problems. And so, I was hoping you could kind of walk us through, you know, what are some of the things that you're seeing that you're concerned about? And then if you've just inherited a patient who had a shunt placed at, say, a different institution, how do you go about figuring out what kind of shunt it is and if they're still dependent on it? Dr Robinson: There's a few things that, fortunately, technology is helping with. So, it is much easier now for patients to get their images uploaded to image-sharing software, and then we can download their images into our institutional software, which is very helpful. Another option is that we are strongly encouraging our families to use a app such as HydroAssist that's available from the Hydrocephalus Association. So that's an app that goes on your phone, and you can upload the images from an MRI or a CT scan or x-rays from a shunt series. And then that you can take if you're traveling and you have to go to emergency department or you're establishing care with a new provider, you can have your information right there and not be under stress to remember it. It also has areas so you can record the type of valve. And all of our valves have pluses and minuses, they all tend to malfunction a little bit. And they can be particularly helpful with different types of hydrocephalus. I really doubt that we're going to narrow down from the fifteen or so valves we have access to now. And so, recording your valve type, the manufacturer as well as the setting, is very helpful when you're transferring care or if you're traveling and then have to, unfortunately, stop in the emergency department. Dr Albin: Yeah, I thought that was a really great pearl that, like, families now are empowered to sort of take control of understanding sort of the devices that they have, the settings that they're using. And what an incredible thing for providers who are going to care for these patients who, you know, unfortunately do end up in centers that are not their primary center. The other challenge that I find… I practice as a neurointensivist, and sometimes patients come in and they have a history of being shunt dependent and they present with a neurologic change. And I think that we as neurologists can be a little quick to blame the shunt and want the shunt to be tapped. And I was really struck in reading this article about the complexity of shunt taps. And I was hoping, you know, can you kind of walk us through what's involved and maybe why we should have a little bit of a higher threshold before just saying, ah, just have the neurosurgeons tap the shunt. Like, it's not that straightforward. Dr Robinson: And it may depend on the population you're caring for. So, when I was at a different institution, we actually published that there's about a 5% complication rate from shunt taps. And that may be- that was in pediatric patients. And again, that may be population dependent, but you can introduce infection to a perfectly clean shunt by doing a shunt tap. You can also cause an acute shunt malfunction. So that's why we tend to prefer that only neurosurgeons are doing shunt taps for evaluation of a shunt malfunction. There are times that, for example, our patients who are getting intrathecal chemotherapy or something have a CSF access device like an Ommaya reservoir, and other providers may tap that reservoir to instill medicine. But that's different than an evaluation, like, you're talking about somebody with a neurological change. And so, it is possible that if somebody has small ventricles or something, if you tap that shunt, you can take a marginally functioning shunt and turn it into an acute proximal malfunction, which is an emergency. Dr Albin: Absolutely. I think that's a fantastic pearl for us to take away from this. It's just that heightened level. And kind of on the flip side of that, you know, and I really- I do feel for us when we're trying to kind of, you know, make a case that it's, it's not the shunt. Many of our shunted patients also have a lot of neurologic complexity, which I think you really talked upon in this article. I mean, these are patients who have developmental cognitive delays and that they have epilepsy and that they're at risk for, you know, complications from prematurity, since that's a very common reason that patients are getting shunts. But from your experience as a neurosurgeon, what are some of the features that make you particularly concerned about shnut malfunction? And how do you sort of evaluate these patients when they come in with that altered mental status? Dr Robinson: It is challenging, especially for our patients that have, you know, some intellectual delay or other difficulties that make it hard for them to give an accurate history. Problem is, if they're sick and lethargic, they may not remember the symptoms that they had when they were sick. But sometimes there's hopefully there's a family member present that does remember and can say, oh, no, this is what they look like when they have a viral illness. And this is different from when they have the shot malfunction, which was projectile emesis, not associated with a fever. It's rare to have a fever with a shunt malfunction, although shunt infection often presents with malfunction. So, it's not completely exclusionary. We often look at the imaging, but it's taking the whole picture together. Some of the common other diagnoses we see are severe constipation that can decrease the drainage from the shunt and even cause papilledema in some people. So, we look at that as well on the shunt series. It's very important to have the shunt series if you're concerned about shunt malfunction or- the shunt tubing is good. It tends to last maybe 20to 25 years before it starts to degrade. And so, you may have had a functioning shunt for decades and it worked well and you're very dependent on it, and then it breaks and you become ill. But on the flip side, we have patients that have had a broken shunt for years, they just didn't know about it. And we don't want to jump in and operate on them and then cause complexities. And so, it is a challenge to sort out. The simplest thing is obviously if they come in and their ventricles are significantly larger, and that goes along with a several-hour or a couple-day deterioration, that's a little more clear-cut. Dr Albin: Absolutely. And you talked about this shunt series. What other imaging- and, sort of maybe walk us through, what's involved in a shunt series, what are you looking at? And then what other imaging is sort of your preferred method for evaluating these patients? Dr Robinson: In adult patients, the shunt series is the x-ray from the entire shunt. And so, if they have an atrial shunt, that would be skull x-ray plus a chest x-ray; or the shunt ends in the perineal cavity, it goes to the perineum. And we're looking for continuity. We're looking for the- sometimes as people grow and age, the ventricular catheter can pull out of the ventricle. So, we're looking to make sure that the ventricular catheter is in an optimal position relative to the skull. We can also look at the valve setting to see the type of valve. So, that can also be helpful as well. And then in terms of additional imaging, a CT scan or an MRI is helpful. If you don't know what type of valve they have, they should not, ideally, go in the MRI scanner. We like to know what their setting is before they go in the MRI because we're going to have to reset the valve after they come out of the MRI if it's a programmable valve. Dr Albin: This is fantastic. I've heard several pearls. So, one is that with the shunt series, which, am I correct in understanding those are just plain X-rays? Dr Robinson: Yes. Dr Albin: Right. Then we can look for constipation, and that might be actually something really serious in a pediatric patient that could clue us in that they could actually be developing hydrocephalus or increased ICP just because of the abdominal pressure. And then that we need to be mindful of what are the stunt settings before we expose anyone to the MRI machine. Is that two good takeaways from all of this? Dr Robinson: Yes. And it's very rare that there'll be an MRI tech that will allow a patient with a valve in the MRI without knowing what it is. So, they have their job security that way. But yeah, if you're not sure, just go ahead and get the CT. Obviously, in our younger kids, we're trying to avoid CT scans. But if you're weighing off trying to decide if somebody has a shunt malfunction versus, you know, waiting 12 or 24 hours for an MRI, go ahead and get the CT. Dr Albin: Absolutely. I love it. Those are things I'm going to take with me for this. I have one more question about these shunts. So, every now and then, and I think you started to touch on this, we will get a shunt series and we'll see that the catheter is fractured. Do the patients develop little- like, a tract that continues to allow diversion even though the catheter is fractured? Dr Robinson: Yes. So, they can develop scar tissue around, and some people have more scar tissue than others. You'll even see that sometimes, say, the catheter has fractured and we'll take out that old fractured tubing and put in new tubing on the other side. But if you go and palpate their neck or chest, you'll still feel that tract is there because it calcifies along the tract. Some patients drain through that calcified tract for weeks or months without symptoms, and then it can occlude off. So, we don't consider it a reliable pathway. It's also not a reliable pathway if you're positioned prone in the OR. So some of our orthopedic colleagues, for example, if they go to do a spine fusion, we like to confirm that the shunt is working before you undergo that long anesthesia, but also that you're going to be positioned prone and you could potentially- you know, the pressure could occlude that track that normally is open. Dr Albin: This is fantastic. I feel like I've gotten everything I've ever wanted to know about shunts and all of their complications in this, which is, you know, this is really difficult. And I think that because we are not trained to put these in, sometimes we see them and we just say, oh, it's fractured that must be a malfunction. But it's good to know that sometimes those patients can drain through, you know, a sort of scarred-down tract, but that it may not be nearly as reliable as when they have the tubing in place. Another really good thing that I'm going to put in my back pocket for the next time I see a patient with a potential shunt malfunction. Dr Robinson: And we do have some patients that the tubing is fractured years ago and they don't need it repaired, and that totally can be challenging when they then transfer to your practice for follow-up care. We tend to follow those patients very closely, both our clinic visits as well as having them seen by ophthalmology. So, there are teenagers and young adults out there that have… their own system has recovered and they are no longer shunt-dependent; and they may have a broken shunt and not actually be using that track, but they usually have had fairly intensive follow up to prove that they're not shunt-dependent. And we still have a healthy respect there that, you know, if they start to get a headache, we're going to take that quite seriously as opposed to, you know, some of our shunt patients, about 10 to 20%, have chronic headaches that are not shunt-related. So, not everybody who has a headache and has a shunt has a shunt malfunction. It's tough. Dr Albin: This is really tough. That actually brings me to sort of the last clinical scenario that I was hoping we could get your perspective on. And I think this would be of great interest to neurologists, especially in the context that these children may develop headaches that have nothing to do with the shunt. I'd like to sort of give you this hypothetical case that I'm a neurologist seeing a patient in clinic and it's a teenager, maybe a young adult, and they had a shunt placed early in childhood. They've done really well. And they've come to me for management of a new headache. And, you know, as part of this workup, their primary care provider had ordered an MRI. And, you know, I look at the MRI, and I don't think that the ventricles look really enlarged. They don't look overdrained. Is having an MRI that looks pretty okay, is that enough to exonerate the shunt in this situation? Dr Robinson: In most cases it is. The one time that we don't see a substantial change in the ventricles is if we have a pseudocyst in the abdomen. The ventricles cannot enlarge initially, and then later on they might enlarge. So, we see that sometimes that somebody will come in and their ventricles will be stable in size, but we're still a little bit suspicious. They've got this persistent headache. They may have, you know, some emesis or loss of appetite, loss of activity, and a slower presentation than you would get with an acute proximal malfunction. We can check an abdominal ultrasound for them. And sometimes, even though the ventricles haven't changed in size, they still have a malfunction because they have that distal pseudocyst. One of the questions that we ask our patients when we're establishing care, in addition to what valve type they have and what sort of their shunt history or other interventions such as endoscopic third ventriculostomy, is to ask if their ventricles enlarge when they have a shunt malfunction. There is a small fraction where they do not. They kind of have a stiff brain, if you will. And so, it's good to know that. That's one of the key factors is asking somebody, do the ventricles enlarge when they have a malfunction? If they have enlarged in the past, they're likely to enlarge again if they have a malfunction. But again, it's not 100%. So, in peds, 20% of the time the ventricles don't enlarge. So, in adults, I'm not that- you know, I don't know what percentage it is, but it's something to consider that you can have a stable ventricular size and still have a shunt malfunction. So, if your clinical judgment, you're just kind of, like, still uneasy, you know, respect that and maybe do a little more workup. That's why we so much want patients to establish care with somebody, whether it's a neurologist or a neurosurgeon or other provider in some areas that have fewer neurospecialists, but to establish care so that you all know what a change is for that patient. That's really important. Dr Albin: That's fantastic. So, to summarize that, it's really important to understand the patient's baseline and how they presented with prior shunt complications, if they've had some. That if they're coming in with a new headache that we don't have a baseline, so, we should just have a heightened level of awareness that, like, the shunt has a start and it has an end. And even if the start of the shunt in the brain looks okay, there still could be the potential for complications in the abdomen. And maybe the third thing I heard from that is that we should look for GI symptoms and sort of be aware of when there could be a complication in the abdomen as well. Does that all sound about right? Dr Robinson: And especially for our kids with spina bifida and for posthemorrhagic hydrocephalus are now adults, because the preterm infants are prone to necrotizing enterocolitis. And they may not have had surgery for it, but they still may have adhesions and other things that predispose them to develop pseudocysts over time. And then our individuals with spina bifida often have various abdominal surgeries and other procedures to help them manage their bowel and bladder function. And so that can also create adhesions that then predisposes to pseudocysts. So, we do have a healthy respect for that. In addition, it used to be---because we have gotten a little better with shunts over time---it used to be, like, when I was in training that you heard, you know, if you haven't had a shunt malfunction for 10 or 15 years, you must- you may no longer be dependent. And that's not really true. There are some people who outgrow their need for shunt dependence, but not everyone does outgrow it. And so, you can be 15, 20 years without a shunt revision and still be shunt-dependent. Dr Albin: Those are fantastic pearls. I think most of them, walking away with this, like, a very healthy respect for the fact that these are complex patients, which the shunt is one component of sort of the things that can go wrong and that we have to have a really healthy respect and really detailed investigation and sort of take the big picture. I really like that. Dr Robinson: Yeah, I know. I think it's- there's a very strong push amongst pediatric neurosurgery and a lot of the related, our colleagues in other areas, to develop multidisciplinary transition clinics and lifespan programs for these patients to help keep everything else optimized so that they're not coming in, for example, with seizures. But then you have to figure out if this is a seizure or a shunt; you know, if we can keep them on track, if we can keep them healthy in all their other dimensions, it makes it safer for them in terms of their shunt malfunction. Dr Albin: Absolutely. I love that, and just the multidisciplinary preventative aspect of trying to keep these patients well. So important. Dr Robinson, I really would like to thank you for your time. We're getting towards the end of our time together. Are there any other points about the article that you just are anxious that leave the readers with, or should I just direct them back to the fantastic review that you've put together on this topic? Dr Robinson: No, I think that we covered a lot of the high points. I think one of the really exciting things for hydrocephalus is that there's a lot of investigations into other options besides shunts for certain populations. We are seeing less hydrocephalus now with the fetal repair of the myelomeningocele, which is great. And we're trying to make inroads into posthemorrhagic hydrocephalus as well. So, there are a lot of great things on the horizon and, you know, hopefully someday we won't have the need to have these discussions so much for shunts. Dr Albin: I love it. I think that's really important. And all of those points were touched on the article. And so, I really invite our listeners to go and check out the article, where you can see sort of, like, how this is evolving in real time. Thank you, Dr Robinson. Please go and check out the childhood-onset hydrocephalus article, which appears in the most recent issue of Continuum on the disorders of CSF dynamics. And be sure to check out Continuum Audio episodes from this and other issues. Thank you again to our listeners for joining us today. And thank you, Dr Robinson. Dr Robinson: Thanks for having me. Dr Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practitioners. Use the link in the episode notes to learn more and subscribe. AAN members, you can get CME for listening to this interview by completing the evaluation at continpub.com/audioCME. Thank you for listening to Continuum Audio.

Send us a textScott and John discuss some favorite songs that mention family members (i.e. Mama, Daddy, Sister, etc...)Youtube: https://www.youtube.com/@narcissisticmusicdisorderJoin us on Facebook at NMD podcast group.nmdpodcast@gmail.com to contact us.Tell your friends!!Be sure to Like and Subscribe. Thanks for listening!

People with a Developmental Visual-Spatial Disorder (DVSD)—a proposed new name for Non-Verbal Learning Disability (NVLD)—experience a range of challenges. Hudson Mohawk Magazine correspondent Caelan McPherson, who has been diagnosed with NVLD, sat down with Dr. Laura Lemle, founder of the NVLD Project, and Dr. Amy Margolis, a researcher and professor involved with the project. They spoke about NVLD, the organization's efforts to raise awareness, educating the public, and providing support and resources to help individuals with NVLD succeed. To find information and resources go to nvld.org.

We're still learning about how to best serve those with autism. Catherine Talbot, assistant professor in the school of psychology at the Florida Institute of Technology, discusses how a hormone for social behavior could help. Catherine F. Talbot is an Assistant Professor in the School of Psychology at Florida Tech. After receiving her B.S. in […]

Each time someone wants to become a British Citizen, they have to pass the ‘Life In The UK' Test. The aspiring Britisher (such as Jason) might hope that this test would be comprised of a series of questions that would highlight Britain's role as a global orderer, help prospective citizens understand the intricacies of British queuing culture and provide insights into how to pay council tax, or get on the ballot for Wimbledon tickets… but in reality: the test is about as Disorderly as the world is currently. In this episode, Jane and Jason discuss the intricacies and absurdities of Jason's experience taking the Life in the UK test. Jason quizzes Jane on what he was made to learn about the supposed essentials of British life, with questions such as: what is a Welsh cake made from? Who won against the Vikings? And ‘what many of crosses compose the Union Flag? [sic]'  And on a serious note, they discuss the very special intellectual contribution of Scots to global civilization and –as they Order the Disorder – they talk about whether Britain can be a convening power – and a genuine Mega Orderer in the mid 21st century world. Producer: George McDonagh Subscribe to our Substack - https://natoandtheged.substack.com/ Disorder on YouTube - https://www.youtube.com/@DisorderShow  Show Notes Links: Recipe for Welsh cakes: https://www.bbc.co.uk/food/recipes/welsh_cakes_16706  Can YOU pass a UK citizenship test? Brits joke they 'better pack their bags' after struggling to answer the general knowledge questions:  https://www.dailymail.co.uk/femail/article-14849235/Can-YOU-pass-UK-citizenship-test-Brits-joke-better-pack-bags-struggling-answer-general-knowledge-questions.html  More than half of the population are unable to pass the UK citizenship test - but how well would YOU do?  https://www.dailymail.co.uk/news/article-13584185/more-than-half-of-the-population-are-unable-to-pass-the-uk-citizenship-test-but-how-well-would-you-do.html  Wha's like us? Damn few' and they're A' deid: https://www.robbiemactours.co.uk/whas-like-us-damn-few-and-theyre-a-deid/   Learn more about your ad choices. Visit megaphone.fm/adchoices

In this insightful episode, Molly sits down once again with Dr. Brooke Scheller, clinical nutritionist and founder of Functional Sobriety, to discuss one of the most buzzed-about topics in the health and wellness space: GLP-1 medications (like Ozempic and Wegovy). Originally developed for treating Type 2 diabetes and now widely prescribed for weight loss, these drugs are increasingly being talked about for their potential to reduce alcohol cravings.Together, Molly and Dr. Scheller unpack the growing curiosity (and concern) surrounding the off-label use of GLP-1s by those trying to moderate or change their drinking habits. They dive deep into both the science and the speculation—discussing small but intriguing studies, anecdotal feedback from clients and community members, and what it really means to find a “magic pill” for reducing desire.But this episode doesn't stop at surface-level discussion. They explore the bigger picture: sustainable behavior change, the role of nutrition in alcohol use, and whether it's possible to replicate the effects of GLP-1s with food, lifestyle, and mindset shifts alone.What You'll Learn in This Episode:What GLP-1 medications are and how they workWhy they might reduce alcohol cravings—and what the science says so farWho might benefit most from GLP-1s—and who should be cautiousCommon side effects and risks associated with these drugsNatural strategies to support craving reduction and metabolic healthWhy addressing core beliefs about alcohol is critical to long-term changeLinks & Resources Mentioned:Dr. Brooke Scheller's program: Functional SobrietyDr. Scheller's book: How to Eat to Change How You DrinkConnect with Molly: Website: www.mollywatts.com Instagram: @alcoholminimalist Join the Private Facebook Community: “Alcohol Minimalists: Change Your Drinking Habits”Want to Change Your Drinking? Download Molly's free guide “Alcohol Truths 2023” and learn how to identify your personal safe level of drinking at mollywatts.com/resourcesLow risk drinking guidelines from the NIAAA:Healthy men under 65:No more than 4 drinks in one day and no more than 14 drinks per week.Healthy women (all ages) and healthy men 65 and older:No more than 3 drinks in one day and no more than 7 drinks per week.One drink is defined as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof liquor. So remember that a mixed drink or full glass of wine are probably more than one drink.Abstinence from alcoholAbstinence from alcohol is the best choice for people who take medication(s) that interact with alcohol, have health conditions that could be exacerbated by alcohol (e.g. liver disease), are pregnant or may become pregnant or have had a problem with alcohol or another substance in the past.Benefits of “low-risk” drinkingFollowing these guidelines reduces the risk of health problems such as cancer, liver disease, reduced immunity, ulcers, sleep problems, complications of existing conditions, and more. It also reduces the risk of depression, social problems, and difficulties at school or work. ★ Support this podcast ★

In June 2022, Canadian superstar singer Justin Bieber took to Instagram to reveal that he has a rare neurological disorder called Ramsay Hunt Syndrome. He took a break from his world tour, and would do the same just a few months later, again using social media to tell fans about suffering with exhaustion and needing to “make health the priority”. After trying to restart the tour, he would eventually be forced to cancel his remaining concert dates. How long have we known about this syndrome? What are its symptoms? Can you cure Ramsay Hunt syndrome? In under 3 minutes, we answer your questions! To listen to the latest episodes, click here: ⁠Is binge drinking over in the UK?⁠ ⁠How can I improve my posture in the office?⁠ ⁠Why should I avoid showering after a workout?⁠ A Bababam Originals podcast written and realised by Joseph Chance. First Broadcast : 8/10/2022 Learn more about your ad choices. Visit megaphone.fm/adchoices

In episode 495 I chat with Gina Abbondante. Gina is a psychotherapist and clinical director at Change of Mind counselling. We discuss her OCD story, panic disorder - having a panic attack as early as kindergarten, blood injection injury phobia, when OCD started, suicidal themed OCD, exposure and response prevention therapy (ERP), inference-based CBT (CBT), working with postpartum and postnatal parents, equine therapy, and much more. Hope it helps. Show notes: https://theocdstories.com/episode/gina-495  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  Thanks to all our patrons for supporting our work. To sign up to our Patreon and to check out the benefits you'll receive as a Patron, visit: https://www.patreon.com/theocdstoriespodcast 

In this episode of the Experience Miracles podcast, Dr. Tony Ebel addresses a critical and misunderstood topic: chiropractic care for children with hypermobility conditions like EDS, Down syndrome, and Chiari malformations. He explains why these children not only can receive chiropractic care safely, but actually need it more than typical children. Dr. Ebel breaks down how hypermobile joints create compensatory fixated segments that become subluxated, requiring specialized mixed-technique approaches. This episode is essential for parents who have been incorrectly advised by other healthcare providers to avoid chiropractic care for their hypermobile children.Key Topics & Timestamps([00:01:00]) - Why Hypermobile Children NEED Chiropractic Care More Than Others([00:03:00]) - Common Conditions: EDS, Down Syndrome, and Chiari Malformations([00:05:00]) - How the Brain Creates Compensatory Fixation in Response to Instability([00:07:00]) - Specialized Techniques Required: Tonal vs. Manual Approaches([00:11:00]) - Why This Care is Essential, Not Optional, for Genetic Hypermobility([00:12:00]) - Medical Doctors' Misunderstanding and the Harm of Avoiding Care-- Follow us on Socials: Instagram: @pxdocs Facebook: Dr. Tony Ebel & The PX Docs Network Youtube: The PX Docs For more information, visit PXDocs.com to read informative articles about the power of Neurologically-Focused Chiropractic Care. Find a PX Doc Office near me: PX DOCS DirectoryTo watch Dr. Tony's 30 min Perfect Storm Webinar: Click HereSubscribe, share, and stay tuned for more incredible episodes unpacking the power of Nervous System focused care for children!

So... my little blue vibrator did me dirty.

Bill O'Reilly reacts to a viral video of good samaritans saving a woman on a New York subway from a crazed maniac, and New York releasing the criminal. Learn more about your ad choices. Visit megaphone.fm/adchoices