Podcasts about DSM

In this episode, Kyle interviews Bessel van der Kolk, MD: pioneer clinician, researcher, and educator on traumatic stress; Founder of the Trauma Research Foundation; Professor of Psychiatry at Boston University Medical School; Principal Investigator of the Boston site of MAPS' MDMA-assisted psychotherapy study; and author of the #1 New York Times Science best seller, The Body Keeps the Score: Brain, Mind, and Body in the Treatment of Trauma. As of this recording, van der Kolk was publishing his last paper and closing down his laboratory, so he looks back on his past: being part of the group who put together the first PTSD diagnosis in the 80s; the early days of psychedelic research and how he discouraged Rick Doblin and Michael Mithoefer from pursuing MDMA research; how the DSM has no scientific validity and was never meant for the diagnosing it's being used for; how science wasn't seeing the whole picture and pushing us mindlessly from medication to medication; and how trauma research has evolved over the years as society learned more about how the mind actually works.  He discusses the struggle to validate “softer” sciences; the impracticality and price of the MAPS protocol and the need for more group and sitter/experiencer frameworks; the efficacy of psychodrama and how that plays out in group sessions; his interest in using the Rorschach test more; how rolfing helped him; the problem with diagnosis and people becoming their illnesses; bodywork, somatic literacy, and how disconnected most people are from their bodies; and how, in all the healing frameworks he's explored, he has never seen anything work as profoundly as psychedelic-assisted therapy. Click here to head to the show notes page. 

Healthy//Toxic Healthy versus Toxic is a podcast where licensed mental health professionals explore what makes a relationship healthy or unhealthy. Our hosts aim to provide a scientifically informed perspective on what factors go into making healthy relationships, how to build secure attachment, and how to be a better parent, child, partner, or friend.  References: Miller, J., Gentile, B., Wilson, L., & Campbell, W. K. (2013). Grandiose and Vulnerable Narcissism and the DSM–5 Pathological Personality Trait Model. Journal of Personality Assessment, 95(3), 284–290. https://doi-org.mylibrary.wilmu.edu/1... Neufeld, D. C., & Johnson, E. A. (2016). Burning with envy? Dispositional and situational influences on envy in grandiose and vulnerable narcissism. Journal of Personality, 84(5), 685–696. https://doi-org.mylibrary.wilmu.edu/1... Rohmann, E., Neumann, E., Herner, M. J., & Bierhoff, H.-W. (2012). Grandiose and vulnerable narcissism: Self-construal, attachment, and love in romantic relationships. European Psychologist, 17(4), 279–290. https://doi-org.mylibrary.wilmu.edu/1... Kealy, D., & Rasmussen, B. (2012). Veiled and Vulnerable: The Other Side of Grandiose Narcissism. Clinical Social Work Journal, 40(3), 356–365. https://doi-org.mylibrary.wilmu.edu/1... Derry, K. L., Ohan, J. L., & Bayliss, D. M. (2019). Toward understanding and measuring grandiose and vulnerable narcissism within trait personality models. European Journal of Psychological Assessment, 35(4), 498–511. https://doi-org.mylibrary.wilmu.edu/1... Mechanic, K., & Barry, C. christopher. barry@usm. ed. (2015). Adolescent Grandiose and Vulnerable Narcissism: Associations with Perceived Parenting Practices. Journal of Child & Family Studies, 24(5), 1510–1518. https://doi-org.mylibrary.wilmu.edu/1... Miller, J. D., Lynam, D. R., Vize, C., Crowe, M., Sleep, C., Maples, K. J. L., … Campbell, W. K. (2018). Vulnerable narcissism is (mostly) a disorder of neuroticism. Journal of Personality, 86(2), 186–199. https://doi-org.mylibrary.wilmu.edu/1... Sandage, S. J., Jankowski, P. J., Bissonette, C. D., & Paine, D. R. (2017). Vulnerable narcissism, forgiveness, humility, and depression: Mediator effects for differentiation of self. Psychoanalytic Psychology, 34(3), 300–310. https://doi-org.mylibrary.wilmu.edu/1... Want more mental health content? Check out our other Podcasts: Mental Health // Demystified with Dr. Tracey Marks  True Crime Psychology and Personality Cluster B: A Look At Narcissism, Antisocial, Borderline, and Histrionic Disorders Here, Now, Together with Rou Reynolds   Links for Dr. Grande Dr. Grande on YouTube Produced by Ars Longa Media Learn more at arslonga.media. Produced by: Erin McCue Executive Producer: Patrick C. Beeman, MD Legal Stuff The information presented in this podcast is intended for educational and entertainment purposes only and is not professional advice. Learn more about your ad choices. Visit megaphone.fm/adchoices

SPOILER ALERT: WATCH ENTIRE SERIES FIRST Chapters Listed Below This video is the third episode to a larger project that examines the toxic family system of The Logan Family on the HBO series, Succession. This episode contains an analysis and themes which will be explored and highlighted as we focus on the character of Siobhan Roy during Season One of Succession. 0:00 Intro 01:48 "Pinky" 03:51 Objectification 06:11 Tom/Relational Dynamic 07:38 Nate 10:54 Avoidant Attachment Style 14:10 NonVerbals 15:10 Shiv's Wedding 17:55 Being "Good" 19:10 Wrapping Up Season One 20:15 Next Episode Website: www.clermontmentalhealth.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email: snap@clermontmentalhealth.care Text: 513-655-6101 ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube Channel⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram: @theofficialsnap FB Page: @mfriedmanlpcc ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SNAP FB Group⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter: @mfriedmanlpcc Mandy Friedman, LPCC-S, CCDVC, CCTP-II, CCMHC is a Licensed Professional Clinical Counselor, a Certified Clinical Domestic Violence Counselor, a Clinically Certified Trauma Professional and a Certified Clinical Mental Health Counselor. Mandy is the creator of the educational recovery program SNAP: Survivors of Narcissistic & Abusive Personalities. This program teaches survivors and concerned loved ones about abusive personalities, targets of abuse, abusive relationships and life in recovery from abuse. SNAP educational program of recovery helps empathic survivors of abuse fine tune and connect with their empathic nature in order to preserve, harness and protect the very things abusers seek to destroy. In her private practice, Clermont Mental Health, Mandy specializes in treating survivors of Cluster B personalities. She is also familiar with the role of addiction, substance abuse and self-harm in abusive relationships. Mandy's clients are often in need of trauma-informed care as part of their recovery. This has led her to specialize treating clients with Complex Post Traumatic Stress Disorder (C-PTSD). To help her clients, Mandy utilizes mindfulness based cognitive therapy (MBCT), cognitive behavioral therapy (CBT), psychoeducation and Polyvagal Theory. Mandy is a survivor of abuse and has first-hand knowledge of what survivors endure in abusive circumstances and living a healthy life after abuse. Disclaimer: This content is intended for educational purposes only. It is not a substitute for mental health treatment. It is important for survivors of abuse to find mental health professionals who understand trauma and abusive relationships. Please seek support from trusted and trained practitioners. This content is not meant to be used by anyone as diagnostic criteria. Permissions have not been granted for anyone to utilize this material as a source to make allegations about specific individuals. Any online content produced by SNAP: Survivors of Narcissistic & Abusive Personalities, Clermont Mental Health or Mandy Friedman LPCC-S is an educational discussion about narcissism which is a descriptive term for tendencies and behavioral patterns. Individuals with narcissistic features or tendencies do not necessarily meet DSM diagnostic criteria. The terms narcissistic and narcissism are used as descriptions of tendencies and behaviors and are not meant as clinical terms. --- Support this podcast: https://podcasters.spotify.com/pod/show/mandy-friedman-lpcc/support

SPOILER ALERT: WATCH ENTIRE SERIES FIRST This video is the fourth episode to a larger project that examines the toxic family system of The Logan Family on the HBO series, Succession. This episode contains an analysis and themes which will be explored and highlighted as we focus on the character of Roman Roy during Season One of Succession. 0:00 Intro 3:11 Abusive Childhood 5:57 Intimacy Problems 9:55 Narcissistic Amnesia & Denial 13:13 Callousness & Cruelty 17:13 Summary ⁠⁠⁠Website: www.clermontmentalhealth.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email: snap@clermontmentalhealth.care Text: 513-655-6101 ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube Channel⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram: @theofficialsnap FB Page: @mfriedmanlpcc ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SNAP FB Group⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter: @mfriedmanlpcc Mandy Friedman, LPCC-S, CCDVC, CCTP-II, CCMHC is a Licensed Professional Clinical Counselor, a Certified Clinical Domestic Violence Counselor, a Clinically Certified Trauma Professional and a Certified Clinical Mental Health Counselor. Mandy is the creator of the educational recovery program SNAP: Survivors of Narcissistic & Abusive Personalities. This program teaches survivors and concerned loved ones about abusive personalities, targets of abuse, abusive relationships and life in recovery from abuse. SNAP educational program of recovery helps empathic survivors of abuse fine tune and connect with their empathic nature in order to preserve, harness and protect the very things abusers seek to destroy. In her private practice, Clermont Mental Health, Mandy specializes in treating survivors of Cluster B personalities. She is also familiar with the role of addiction, substance abuse and self-harm in abusive relationships. Mandy's clients are often in need of trauma-informed care as part of their recovery. This has led her to specialize treating clients with Complex Post Traumatic Stress Disorder (C-PTSD). To help her clients, Mandy utilizes mindfulness based cognitive therapy (MBCT), cognitive behavioral therapy (CBT), psychoeducation and Polyvagal Theory. Mandy is a survivor of abuse and has first-hand knowledge of what survivors endure in abusive circumstances and living a healthy life after abuse. Disclaimer: This content is intended for educational purposes only. It is not a substitute for mental health treatment. It is important for survivors of abuse to find mental health professionals who understand trauma and abusive relationships. Please seek support from trusted and trained practitioners. This content is not meant to be used by anyone as diagnostic criteria. Permissions have not been granted for anyone to utilize this material as a source to make allegations about specific individuals. Any online content produced by SNAP: Survivors of Narcissistic & Abusive Personalities, Clermont Mental Health or Mandy Friedman LPCC-S is an educational discussion about narcissism which is a descriptive term for tendencies and behavioral patterns. Individuals with narcissistic features or tendencies do not necessarily meet DSM diagnostic criteria. The terms narcissistic and narcissism are used as descriptions of tendencies and behaviors and are not meant as clinical terms. --- Support this podcast: https://podcasters.spotify.com/pod/show/mandy-friedman-lpcc/support

Rejection sensitive dysphoria (RSD) impacts many aspects of your life and can be a driving force in how you manage relationships and internally process the world around you, so there are many nuances for it. In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, answer some of the questions from listeners about RSD, including everything from self-shaming to the connection with other diagnoses. Top 3 reasons to listen to the entire episode: Understand what masked RSD looks like and the impact it has on shame and finding connection. Identify what connections and impact RSD might have on conditions like PMDD, as well as how the experience of rejection can be viewed differently between ADHD and Autistic individuals. Learn some strategies to help deal with the experience of RSD to create a better environment around you and pay attention to your core needs. When it comes to RSD, everything goes back to connection. It's both the thing that humans need and also something that can seem so difficult to attain and maintain. If you are struggling with complex and shifting intrusive narratives or internalized emotions that can last for years, try to focus on your core needs at the moment and check in with yourself so that you can offer yourself the opportunity to think more objectively and take action that is more likely to benefit you. Resources plus Exclusive Coupon Code Dr. Neff's Rejection Sensitive Dysphoria Workbook Bundle (Clinical Use): https://neurodivergentinsights.com/neurodivergentstore/p/rejection-sensitive-dysphoria-clinical  Dr. Neff's Rejection Sensitive Dysphoria Workbook Bundle (Personal Use): https://neurodivergentinsights.com/neurodivergentstore/p/rejection-sensitive-dysphoria-bundle Use Code: “DivergentConversationsListener” To get 20% off anything in the shop, including the RSD bundle.  Dr. Neff's free blog posts on RSD: https://neurodivergentinsights.com/blog/category/Rejection+Sensitive+Dysphoria    A Thanks to Our Sponsor, Tula Consulting! ✨ Tula Consulting: We would love to thank Tula Consulting for sponsoring this episode. Workplace communication can be messy. Considering the lens of neurodiversity can be helpful for understanding this. Maybe you found yourself frustratedly typing "per my last email" in an office communication, perplexed about how a colleague or client doesn't seem to understand your very clearly written email. Consider this. Visual information processing isn't everyone's strength. Perhaps a quick call could make a world of difference. Or how about including a video or voice message with your email? And this technology exists! Simple steps like these can make your work environment more accessible and bring out the best in everyone. Tula Consulting is on a mission to help organizations build more neuro-inclusive products and work environments. Tula does this by bringing curious minds to solve curious problems. Find out more by visiting tulaneurodiversity.org.   Transcript PATRICK CASALE: All right, so we are back with RSD part three, which will probably lead into an eventual RSD part four. But last week, we did not get to all of your questions, we kind of diverged, and we want to get to more of them today, especially, the ones that we think we have a lot to talk about. So, I think we want to start off with what can highly masked RSD look like? MEGAN NEFF: Love that question, first off. So, last month when I was, like, deep in RSD mode, making the workbook, I created a grid, which… this is my like pattern finding, so I just want to tease out it's not like in the clinical research. But I made a grid of overlain RSD responses on top of kind of like the fight, flight, fawn, freeze, and talked about different responses. And we talked about this a little bit in our first episode. But like the fawn and the freeze response, I would say are masked RSD responses. And so this could show up as like perpetual people-pleasing, right? And perfectionism, those two. The myth being if I never make a mistake, or if I never make someone upset with me, then I would never have to experience this really painful thing. And so a lot of masked RSD looks like really high-performing, high-achieving kind of busybodies ways of being in the world. And then I think when the RSD doesn't really get triggered, because none of us are perfect, and even if we're people pleasers, we're going to have miscommunications with people. I think that experience gets very internalized. So, instead of perhaps an emotional or angry outburst, what you're going to see is things like perhaps substance use, or a lot of negative self-talk, and rumination, and retreating, in some cases, self-harm, and other really like that…. And taking the pain internal. Like, also talked about as internalization, you're going to see a lot more of that. So, the people around you might not actually even know you're having an RSD trigger. PATRICK CASALE: Yeah. And you know, those are the moments, right? Where we could use the language for a lot of self-destructive behavior going on behind the scenes to be able to keep up appearances, to be able to apply that social lubricant, like you've mentioned before, of this is how I fit into these spaces, this is how I show up, this is how I can people please, this is how I can socialize. And then that burnout just really takes over, right? Because there's going to be intensified depression, there's going to be intensified burnout, there's going to be intensified anxiety going on behind the scenes. And you, kind of, like, starting each day from a negative energy reserve and trying to get it back at that point in time where you're like, I'm operating at like negative percentage, and I'm going to put myself into the situation again, and again, and again. MEGAN NEFF: Absolutely. And then we've also got to consider shame dynamics, which also perpetuate all those things you just mentioned of people with internalized RSD would have a lot of shame dynamics going on, which perpetuates a lot of like negative coping. And here's the thing about shame, so shame theory is really interesting, actually. But one of the tricky things about shame is that sometimes there's this belief we fall into or trap. Like, if I can self-shame enough, I can protect from other shame, right? So, self shame it's the shame we give ourself. Other shame is the shame we experience from others. So, people with very internalized RSD who are, you know, people pleasing, perfectionistic, tend to have really harsh inner critics that are very shame-based and have a really hard time diffusing and unhooking from these inner critics partly because the inner critic feels really protective. Because if that inner critic is, "I'm going to shame you, so you don't experience shame from another person." It's playing a protective role. Now, we would argue it's not actually protecting or helping the person, right? But it feels like it's incredibly protective. Most of my life I've had a very, very harsh inner critic. And yeah, I couldn't unhook from it until the last few years because I was like, "No, this is protecting me." So, self shame protecting from other shame. PATRICK CASALE: Yeah, shame is one of those emotional experiences that is probably one of the most painful things that happens to a human being, I think, that that shame spiral is so incredibly painful, destructive, torturous, hellacious. I mean, the criticism that ramps up the internal dialogue. I tend to go into more of like a shutdown space when I'm feeling really shameful. I noticed that comes up a lot when I feel like I can't do something that I feel like I should be able to easily do like screw something in in a way that looks even, or not cause a hole in the wall, or having to call a handy person after that because I've created said issue. That happens a lot. Then there's the social shame component where that really happens with the RSD triggers for me, where it really does create this almost like existential dread component to where you are really questioning everything and anything and almost losing sight of your sense of self in those moments too. MEGAN NEFF: Oh, I think we absolutely lose sight of ourselves in shame spirals. Yeah, so that's kind of, I guess, clinical or lexiconic, if that's the word, definition of shame, just in case people aren't aware. So, guilt is the experience of like, I've done something bad and guilt is actually a good experience. Right? It's helpful feedback. For one, we're not living consistently with our values. Shame, on the other hand, is I am bad, right? It's like I am the bad object, I am bad. And so that experience of I am bad. It's interesting, as we're talking about shame I'm like, how are we three episodes into RSD and we haven't talked about shame yet? Or even how did I write a workbook on RSD and not to talk about shame? Because I think, really what we're talking about it is when the shame is activated relationally because I think that is what happens with the RSD trigger is it's, I let this person down, or I like hard feedback, I am bad, right? And it's such a quick narrative we drop into, I am a bad person, which is the shame narrative. PATRICK CASALE: For sure. So much of our sense of self, self-worth is connected too. And that narrative of I am bad, or I am unworthy, or I am not good enough, or all of the things that start surfacing, oh, man, I've seen so many, just situations where shame has created this spiraling sensation that has created an immense amount of destruction in people's lives in terms of both therapeutically and personally, and from my own perspective for myself. So, it is one of those emotions that is just really, really painful. MEGAN NEFF: Yeah, absolutely. PATRICK CASALE: I mean, we're talking about associations right now and we're talking about shame, we're talking about guilt, we're talking about sense of self that all gets triggered. We start to also see, and I just want to use a trigger warning, but we do start to see an intensified sense of suicidal ideation with a lot of this, too. MEGAN NEFF: Yeah. Oh, I mean, yeah, shame and suicidality absolutely walk hand in hand. So, when you're doing a suicide assessment, there's questions you ask, and how a person answers some of those questions are indicative of how much risk they're in. And one of those questions that tells us this person is in a really high-risk bucket is do you believe or feel that the people in your life would be better off if you weren't here? And shame seduces us into that really painful narrative, shame and many other things, depression, but… PATRICK CASALE: Yeah, I personally think that shame is one of the most damaging and destructive things that we experience. So, heaviness aside, techniques and strategies to work through that shameful experience when it's coming over you because there are ways to not let it engulf you and drown you in a way where, you know, it can be that devastating and destructive too. MEGAN NEFF: Yeah, I mean, Brene Brown is really the queen when it comes to shame, right? Like, I love the idea that vulnerability is the anecdote or the cure to shame. And I think that's part of why when we have internalized RSD we're so prone to some of the like negative coping, because we're less likely to reach out and be like, "Hey, I'm having this experience right now." We probably feel shame about the experience, right? Like shame about being too sensitive, shame about our shame. So, reaching out becomes incredibly difficult. But if we can find someone, whether it's a therapist, or a friend, or a partner who gets it and where we can give that shame some breathing room, and by breathing room not like room to expand, but like room to dissipate, right? Where it doesn't live inside so intensely, that is one of the most powerful things we can do to disrupt a shame spiral is to connect, which again, like we're talking about relational shame, right? So, like belonging has been threatened. It makes sense that connection would be the anecdote to that. PATRICK CASALE: And it also makes sense that it would be the last thing that you would reach for when you're feeling like, "Oh, I'm really feeling this massive amount of shame or rejection. I know I need connection, but I can't reach out for it, because that makes me feel too vulnerable, that makes me feel unsafe. I don't feel worthy of connection." Whatever the internal dialogue is, it makes it that much harder a lot of the time. MEGAN NEFF: Yeah. Well, it's interesting, I'm thinking about the matrix and I'll, like, find a way to make a one page infographic of this that I'm referring to, and we can attach it, because the other parts of the matrix are fight, flee. And I'm just seeing how all of these reactions, all of these stress reactions to RSD move us away from what we need, they move us away from connection. So, if we're fleeing, obviously, that's going to move us away from connection in the in the fight. That's where I would say projection comes online, and where the shame is so intolerable to feel it gets projected onto other people, and then we lead with anger. That's a way of pushing people away. So, whether it's like we're retreating in our pain internally, we're fleeing, or we're projecting all of these move us away from what we need, which is connection. And so, I think that's a lot of work living and working with RSD is figure out like, these are going to be my, like, automatic stress state responses. How do I override that to actually address a coordinate here and move toward that? PATRICK CASALE: Yeah, I think that's a great point. And if we can anchor into the idea that foundationally at the root of this is the desire and necessity to have connection yet the fearfulness or inability to feel like you can access it, and just constantly trying to anchor in, and remember, like, connection is at the root of this, right? Like, as humans, relational beings, regardless of we're introverted, extroverted, does not matter, we still need connection in some capacity. That's something that we absolutely need and it's a major… What am I going to say? It's majorly a part of our makeup. And when we don't have access, or we feel like it's not possible, or we don't have those people in our lives we can turn to, then this can really start to spiral out of control, I think, and this is where we see this really get to that negatively impactful place, and that really destructive place too. I'm not finding my words appropriately right now, but I just want to emphasize the importance of connection. MEGAN NEFF: I feel like I was tracking. I didn't notice that. I feel like I could linger in this conversation if this feels poignant and important. I'm also aware we talked about trying to get through questions in this episode. PATRICK CASALE: Oh, yeah. We did [CROSSTALK 00:14:08]- MEGAN NEFF: Should we move on to the next one? PATRICK CASALE: Let's put in that one question because I think that the topic of shame, in general, could be an entire series. MEGAN NEFF: Let's do an episode on neurodivergent shame because shame is very much part of the experience. It's often tied to, like, of course, past relational experiences we've had, internalized ableism, and then a lot of us have co-occurring trauma and trauma and shame are also very, like part of what's traumatizing about trauma is the shattering of self that often happens in trauma. So, yeah, let's do a shame episode or episodes, because it's a big topic. PATRICK CASALE: Yeah, so for everyone listening, if shame is important, it feels like it's a part of your experience, which I assume for most of you it is, including ourselves, we will do more episodes on shame and specifically focused on that topic. But we do have other questions that we want to get to, if we want to make it an Answer Your Questions episode. So, one question was RSD linkage to PMDD. So, you wanted to take that one? MEGAN NEFF: Yeah, I mean, I think we should do an episode on PMDD, and just like neurodivergence and hormones at some point. Anyways, but PMDD is essentially, oh my gosh, what does it technically stand for? PATRICK CASALE: Post-menopausal dysphoric disorder? MEGAN NEFF: Good job. Yeah, I've been referring it to PMDD so long. I was like, I'm not going to get those letters right. Thank you. So, it's kind of- PATRICK CASALE: [CROSSTALK 00:15:47] also dysphoric disorder. MEGAN NEFF: I mean, it's like PMS on steroids, essentially. PATRICK CASALE: Yeah, it's called that. MEGAN NEFF: So, basically, yeah, PMS on steroids, the clinical definition, PMS on steroids. PATRICK CASALE: Going into the DSM 6 soon, premenstrual dysphoric disorder? MEGAN NEFF: Yeah. And it's very connected to like how hormones are shifting as part of this cycle. And both autistic and ADHD people who have a estrogen cycle, would that be the way to say it? That experience a cycle are much more vulnerable to do both PMS and PMDD. And one of the things about PMDD… PMDD can be really intense. Like, I've definitely seen cases where someone baseline mood is actually pretty okay but will experience like, acute suicidality in that like week or that period. Like, it can be that intense. It's not that intense for everyone, but for some people, it is that intense of a mood shift. So, absolutely, like, I describe it as like just paper thin, like in the sense of like everything's getting in, in that period. So, emotions are going to be heightened. So, of course, RSD, if someone has a baseline RSD, that's also going to be heightened because RSD is connected to emotion regulation. So, with PMDD, emotional regulation becomes a lot harder. And we tend to feel things more intensely. So, yeah, I hadn't actually thought about that, but I love that of that thought experiment of what RSD looks like in that window of time. And I think that's actually really helpful to know. Because it's not going to make it go away, but being able to say like I know RSD triggers are going to be big this week, I'm probably going to perceive rejection where it's not, I'm going to feel it deeply. It doesn't mean it's true. Like, being able to do that self-talk. Like, I don't know whether I have PMDD. But I definitely have like hormonal shifts. I'll tell myself typically that week, "Don't trust your mind. You're not allowed to think about the future, you're not allowed to evaluate relationships." Like, I have like hard rules about what my mind is allowed to do that week. And it's not like a harsh rule. It's like a kind, like, parental figure come in and be like, "You know what? Your mind's not up to any good this week." So, there's some things we're just not going to think about because it's not going to be helpful. Here's what we're going to do instead. PATRICK CASALE: I love that. MEGAN NEFF: Yeah, but yeah. Sorry, go ahead. PATRICK CASALE: No, that's great. I mean, man, you can make worksheets, or like affirmations, or guidelines for people around like that sort of structuring in terms of, I'm not going to trust my mind this week. Like, these are the things that you know to be true, these are the things that we're not going to put any energy into. Like, that makes so much sense. Okay, add another episode to the list of neurodivergence and hormones. So, moving on through the questions, these are leading to episodes which we love. So, thank you for submitting these. Okay. Do stimulants cure RSD? That's a pretty basic response and we're going to say no to that. There are stimulant medications, right? Megan talked about the psychopharmacological perspective in episode one of things that do help in some capacities. But if we're going to just make a blanket statement that say stimulants do not just cure or help RSD in that capacity. Okay, we did highly masked RSD. What else did we say we were going to talk about? MEGAN NEFF: I think autistic versus ADHD, and that was a question that came in. So, you'll hear autistic people and ADHD people talk about RSD. Like, there's a lot of resources out for both. Now, I actually didn't realize this till I started doing the deep dive about… as soon as questions come up, like is RSD specific to ADHD? So, first of all, I see a lot of like monopolizing of experiences. Like, I see a lot of autistic people who are like only autistic people have sensory sensitivities, which isn't true. So, I just want to caveat that. Like, anyone can be high on the rejection sensitivity spectrum, right? This is a spectrum of humanity. RSD as a term, as a concept, as something we talk about is specific to the ADHD literature, in the sense that it's come out of ADHD literature, you know, the projections are like, I don't know how scientific this is, but according to Dr. Dotson, like 99% of ADHDers experience this. Like it's a very core component of ADHD. Other people might be very high in the rejection sensitivity spectrum for different reasons. You know, attachment style, trauma, autistic. Like being misperceived, internalized ableism. Is it RSD if a person's autistic and not ADHD? I don't know. Like, I don't know if we would apply that term. We could say there might be really high in the rejection sensitivity. I have noticed when working with autistic-only populations, it's like hit or miss. Like, maybe they have it, maybe they don't. But I also see people where it's like, I don't really care what people think about me. Like, that's also present. So, autistic people do experience victimization, and like social bullying, and marginalization, they're neuro minority. So, I think there's a lot of reasons why autistic people would also be high on rejection sensitivity. And then we know a lot of autistic people who are also ADHD. So, I think I didn't provide clarity, I just explained how muddy the waters is. PATRICK CASALE: That's okay. Sometimes that is the answer, though, how muddy the waters are, because… And I'm also thinking as you're talking, right? Like, we know so many people are undiagnosed either autistic or ADHD, and how much gets missed. So, I'm just wondering just how many people out there who identify as ADHD, who are also autistic, but unknown, or undiagnosed, and vice versa, and how so much of that also plays a role into the prevalence of RSD showing up as well? MEGAN NEFF: Absolutely, absolutely. Yeah. I will say, oh, this was after you left, you had to dip out for a meeting, when we interviewed Amanda for Ask An Autistic I asked about this. And at first, it was kind of like, yeah, maybe some RSD. And then we talked about like, okay, what happens when… and because we're both on social media, why I asked explicitly about that, she's like, "Yeah, these narratives come on and then, you know, I've usually worked through it in like five or 10 minutes." And I was like, "Five or 10 minutes?" Like, I still get intrusive thoughts about experiences, or even like, this is embarrassing to admit, like comments that I got two years ago, where like, if I embarrassed myself, or did something I'm not proud of, I still get intrusive memories about that like 20 years later. That's a pretty different experience than being able to move through something fairly quickly. And I know Amanda's just one autistic person. But that was a really interesting moment in our conversation, when, like, yes, painful, yes, hard. But the ability to have the tools to work through it without it like bouncing back for me, I work through it, but it keeps bouncing back. And then I have to work through it again. And that's part of that intrusive kind of overtaking. PATRICK CASALE: That's a great point because that actually makes me remember what I was saying for my group practice. So, shout out to Dr. Bennett Harris who's going to rub that in my face that I named him on this podcast. But saying like, these things linger for years sometimes, right? And that's something we haven't addressed yet, is the length of time. I know you've addressed it in your workbook, but we haven't addressed on air that this can bounce back, like you just mentioned for years. And it can be something where you can look at it when you're in a healthy like cognitive space where you're like, "Okay, this comment, I've worked through it." But then maybe something thematic, or something similar comes into play, and it hits you, or it impacts you in a way that you didn't expect. And all of a sudden you're right back to that comment from two and a half years ago. MEGAN NEFF: Yeah, yeah absolutely. Yeah, I'm glad we're talking about that because that's a part of RSD that like, A, it's just confusing and B, it's really stressful to just like be going throughout your day and like all of a sudden intrusive, like, embarrassing or shameful memory pops up and you're like back in it. Like, yeah. Okay, this is kind of a silly example. But we were filming an episode, and we were talking about how we need to do RSD, and we were like speaking of RSD, we just got our first like one star review. And in the moment I was like, you know, like talking through like, okay, that makes sense. But then that comment kept popping in my head throughout the day. And sometimes when I think about this podcast, like that just pops back up. And it feels so silly. And then the secondary narrative of like, "Megan Anna, why do you care about this?" Right? So, it's not just the interest of memory, there's often a second narrative that comes on up like, why are you still holding on to this? Especially, if it's something like that or like, I feel like that's petty. And I should be able to just release it, then there's a second narrative of like, why are you still thinking about this? Why can't you release it? Why can't you get over it? PATRICK CASALE: Let's talk about the secondary narrative, because I think that's so important that you just named that. One, I'm sorry for bringing that up on air, won't ever do that again. MEGAN NEFF: No, I'm glad you did. It's a good live example. And it's like, yeah. PATRICK CASALE: I think we're onto that ship forever. I cannot tell you how often I check All Things Private Practice and Divergent Conversations Apple Podcast reviews. Why am I doing this to myself? Like, why am I going on there knowing that there could, eventually, be a one star review? Like, I should be able to let that go and then that will destroy me for days. I don't know why. That's self-inflicted, it's not healthy. The secondary narrative, that process, right? Of, okay, this experience, this reaction is creating this sensation, it's creating RSD, it's creating distress, then the secondary narrative that's trying to rationalize said reaction that is exhausting to bounce back and forth between narrative one and two over and over and over and over and over again. MEGAN NEFF: Yes, and one thing I've observed, because the neurodivergent brain as well, so divergent is that we often have, like, overlapping narratives. I'm doing this with my hands of like, we'll have an experience, and then we'll have a narrative about it, and then we'll have a narrative about the narrative. And so one thing I've noticed, and I've started to be more careful with this, so I don't do too much CBT, I do have more of a mindfulness approach to like, let's start noticing your thoughts. What I've noticed, and I think, especially, with neurodivergent people, sometimes once they started noticing their thoughts, they got worse. So, like, there's an experience of this. So, the next week came back and like so much worse. So, it's like, okay, let's unpack what's happening here. And it was the secondary narratives. It's now that I'm observing my thoughts, I'm having so much judgments, and evaluations, and feelings about those thoughts. And so then you have to teach how to become mindful of the secondary narrative, right? PATRICK CASALE: RSD about the RSD. MEGAN NEFF: Yeah, yeah. RSD about the RSD. And invalidation, right? Like, I think we're really good at invalidating ourselves in those narratives. Yeah, yeah. PATRICK CASALE: I'm going to try not to diverge too much, because we said we were going to stay on course, which we should always know it's never going to happen. I'm thinking about like, secondary narratives, and how often I have to verbally process them out loud. Like, I will talk myself through the secondary narratives a lot of the time, and how often my wife looks at me in the house. And she's like, "Who the fuck are you talking to?" And I'm like, "I am talking through like my internalized experience and my thoughts that are happening right now and processing them out loud to try to pick them apart to decide what feels rational versus irrational and what feels like there's a linkage to." And she's like, "Is this happening in your brain all the time?" And I was like, "This is happening in my brain all the time." MEGAN NEFF: Yeah, yeah, absolutely. It's weird to me that it's not happening for everyone inside their brain all the time. Like- PATRICK CASALE: Like, this isn't taking up all this mental real estate 24/7 for you? People were like, "What?" She looked at me like, "How do you sleep?" And I'm like, "Well, you know the answer to that, not well." Oh, my God. MEGAN NEFF: Yeah, we have busy minds. And so I think learning how to work with our mind it becomes really important. PATRICK CASALE: Sometimes that is that mindfulness. Like, for me when I hear the word mindfulness, right? And I'm really going to diverge is I hate that word. MEGAN NEFF: I do too. I do too. PATRICK CASALE: Because I associate it with like being still- MEGAN NEFF: Meditation. PATRICK CASALE: Meditate. MEGAN NEFF: Come to your mind. PATRICK CASALE: Exactly. Yeah, that's not going to happen. MEGAN NEFF: No. PATRICK CASALE: But I would much rather apply mindfulness in the way that you do, which I think you said was like, I cannot remember the term that you [CROSSTALK 00:29:38]- MEGAN NEFF: Oh, mindfulness on the go. And I searched it up after that. And there actually is a book that was written a long time ago with that same term. So, I did not come up with the term. I mean… PATRICK CASALE: But I like what you mentioned, right? Like, you're being mindful about the temperature of your smoothie in the morning, or your water, or you're being mindful about the fact that your mind is diverging into a million different directions. And instead of like saying, "Oh my God, my mind is diverging into a million different directions. I need to shut it down. There's something wrong, I can't do it." I'd rather say my mind is diverging into a million different directions. And I'm just being mindful of that. MEGAN NEFF: Yeah, yeah. So, when I think about mindfulness, like I like the imagery of tagging. Like, I feel like a lot of what I'm doing is tagging, like, oh, that's what that is, that's what that is. So, it's like naming, tagging, and… PATRICK CASALE: List making. MEGAN NEFF: Yeah, what did you say? PATRICK CASALE: List making MEGAN NEFF: List making. Well, no, I think I would think of list making as more like you're in the content. And when I think about mindful tagging, it's more of an observational process. That's a really subtle distinction. And that's part of it. So, I like the imagery of like, observing mind, evaluative mind, and what mindfulness, like it's not an activity, it's a way of being, it's a way of being with self. So, whenever we're in observing mind, like that observer who's not judging, not evaluating, but like tagging, like you're having this experience, this is the script that's happening, you're in observing mind. And you can do that while being busy. Like, you can do that. You don't have to sit and listen to a 10-minute meditation and try to empty your mind. For me, when I tried to do those exercises, then all of the evaluation scripts like I can't do this, this is so hard for me, my body physically feels uncomfortable. PATRICK CASALE: Yep. And that can even lend itself and I'm going to get us back on track in a second. But that can even lend itself to being dismissed in the medical and mental health care system where medical professionals are like, "Have you tried mindfulness for sleep?" And you're like, "The fuck? Yes, of course, I have tried mindfulness for sleep. I am neurodivergent. Do you understand how that mean? How the brain works?" Yes, I have tried it. Have I ever tried to like tag and be mindful of a million different thoughts simultaneously while looping them all together? Like, that's every night of my experience? Of course, I've tried that. Yeah, anyway, I don't want to diverge that way. So, you wanted to also get to the topic of… MEGAN NEFF: Oh, yes, yeah. PATRICK CASALE: … slash [CROSSTALK 00:32:20]… MEGAN NEFF: So, we got a couple of questions about like, how do you tease out RSD from trauma, from attachment stuff? Which is great question. So, first, I think whenever we get the, like, tease out questions, I want to first ask, like, for what cause? Or for what purpose are we teasing this out? If it's like, I don't know what the diagnosis is, if you're a clinician, that's going to be a very different conversation. And if it's like, this is a known neurodivergent person. So, I mean, it's physiologically the same things happening, right? Like, the sympathetic nervous system or shut down mode, like it's been activated, a stress state has been activated. We're responding to something relational like, so teasing out like what are the triggers? So, in the context of trauma, and well, that also gets complicated over time about PTSD with a specific trauma, we're talking about complex trauma? But like, what are the triggers around it? Same thing with attachment. But honestly, I have a hard time teasing out like, what is anxious attachment and what is RSD, because if criticism, or feedback, or someone being disappointed in you, that's going to be an attachment injury. So, in attachment theory, we talked about attachment injuries, and that's going to activate stuff. So, yeah, again, muddy waters. When it's the neurodivergent person who also has trauma, also has insecure attachment, that point it's like a soup, right? Like all of these things are intersecting. And which means, also, like on one hand that could feel disempowering, but on the other hand, it means like, as we heal from trauma, as we move toward more secure attachment, everything's going to get better, right? The whole system's going to get better. Okay, I feel like I've talked or rambled. Let's stop for now. PATRICK CASALE: When you say it's, you know, muddy waters and like a soup, I think that's, again, I know so many of you want clarity on this. And I think sometimes there's not a lot of clarity to be given, because so many [CROSSTALK 00:34:44]- MEGAN NEFF: …things intersect. And these are constructs, right? Like attachment theory. Like, these are constructs we've put on top of experiences. PATRICK CASALE: Right. MEGAN NEFF: But they're limited. PATRICK CASALE: Absolutely. MEGAN NEFF: Now, it's totally up to you. PATRICK CASALE: No, that's fine. We're both having thoughts at the same time. But the one takeaway when we're talking about attachment trauma, if we're trying to like differentiate, if we're trying to… okay, if we want to put RSD over here versus what's anxious versus what's avoidant versus what's complex PTSD? Gets really murky. But what is at the foundational level of all of these things? It's something we've talked about several times already in the last two hours, connection. Attachment trauma is about connection. RSD, ultimately, is about connection, complex PTSD, there's going to be layers of unsafe or unhealthy connection. And I think that so often we're missing this mark of like, we want so badly to understand what's happening to us or our own experiences, right? But at the end of the day, foundationally, at our core, it comes back to connection, and our desire to have it, and our inability sometimes to receive it, or maintain it. And I think that that impacts everything that we're talking about. MEGAN NEFF: I love that of like, get back to the basics. And I think, especially, with autistic people, I can see this of like, we want to know precisely what's happening, right? So, like, what's the RSD? What's the trauma? What's this? I don't know how helpful that conversation is, but I do know that what's helpful is getting down to the core need. Like, okay, this is a painful moment, what do I need in this moment? And getting back to that like? And yeah, typically, a lot of these things are connection, belonging, these are the things that are being threatened, and this is what I need right now. So, getting back to the basics in those moments, I think, is ultimately, typically, going to be more helpful than like, is this attachment is this? It's like it's all the things, right? It's all the things intersecting in a difficult moment. PATRICK CASALE: Exactly. And what usefulness does it serve if we're just throwing label on top of label on top of label, because like, there's such a bad negative stereotype with avoidant attachment as there is, and then you throw, you know, the label of autism or neurodivergence, and people are going to have their own experiences around this. And I think, if we just circle back to connectivity, and just the ability to have relationships, and what are we missing? What are we feeling like we're really having painful experiences around? The attachment label doesn't matter as much. Like, it just gets so complicated and convoluted then, or trying to, like, parse apart, you know, things that are really deeply connected and interwoven too, and it's really hard sometimes to get a sense of like, where does this go? And where do I place this? MEGAN NEFF: Yeah, yeah, absolutely. And I think, partly, like, we have to get into how is the label being used? You know, I take a very constructivistic approach to language in general. Like, I prefer language that is most helpful. So, for some person, like talking about like, oh, my attachment system is activated right now. If that's the most helpful for you attuning to yourself, and validating your experience, use that language, right? If it's more helpful to be like, "Oh, my RSD is activated right now." Use that language, use that frame. But how these labels are being used, I realized, like for myself, I often use these labels in that mindful tagging way that we were just talking about of like, "Oh, this is happening for me right now." But I'm very aware that those labels could be used and have a very different experience for someone, right? It could be like, a shame base. Like, this thing is activated right now and I'm so like, mad about it and mad at myself. Or it could be used as a distancing, right? Distancing from the core wound, distancing from the core need by saying, "Oh, that's RSD." And then, like, just leaving it at that. It could be a way to emotionally distance from the pain. So, as much as the label is important, I think, more so like, how is that label being used? What's the internal experience of it? PATRICK CASALE: I just lost your sound for a second. MEGAN NEFF: Oh. PATRICK CASALE: You're back, okay. I heard how is this label being used? How is this label being experienced? Is that it? MEGAN NEFF: Yes. And then I was done. So, I just feel like I ended the sentence. PATRICK CASALE: Maybe that was it. But yeah, I agree 100%. And I think if we can kind of incorporate some of those techniques, and strategies, and just ways of thinking about this it could be a little bit less painful. And it's given me a lot of ideas right now, which is not where I want my brain to be going, and to diverging into all these ideas because I've got to get into other meetings. But I have so many ideas for episodes based off of these last couple of conversations. And again, I just want to highlight how helpful these Ask The Audience sessions can be, because, one, we want your feedback. Those of you who are listening, we appreciate all of you. That feedback has been very helpful, constructive, positive, and we do not take it for granted. And we want to answer these questions because we know a lot of this experience is feeling confused, feeling overwhelmed, feeling [INDISCERNIBLE 00:40:26], feeling disconnected, feeling alone, and we want to help maybe make this a little bit more of a human experience for all of you involved. Megan's just [INDISCERNIBLE 00:40:42]. MEGAN NEFF: I'm feeling like that was the conclusion, episodes are out every Friday. PATRICK CASALE: Yeah, episodes are out every Friday on all major platforms and YouTube. And goodbye. MEGAN NEFF: It's like a compulsion now, Patrick. I like have to make it awkward at the end. PATRICK CASALE: I mean, you're doing a good job. MEGAN NEFF: I honestly I'm not trying. It's just like, okay, that was the summary. You look at me. I don't know what to add. I feel like if I add anything I'll have ruined yourself your beautiful summary. My voice is now going out. PATRICK CASALE: Just that. MEGAN NEFF: Goodbyes are rough. PATRICK CASALE: All right, goodbyes are rough. Goodbye.

L'idée pourrait prêter à sourire, et pourtant, les personnes qui en ont souffert relatent une expérience très désagréable. Le syndrome de Paris, ou plus largement syndrome du voyageur, résulte d'une inadéquation entre les attentes d'une personne lorsqu'elle décide de visiter Paris, et ce qu'elle y trouve réellement. Comment identifier un syndrome de Paris ? La gamme de symptômes qui englobe le syndrome de Paris est vaste. Régulièrement, les individus touchés développent des crises de stress ou des bouffées d'angoisses intenses. Ils peuvent se sentir dépersonnalisés, désorientés, et même connaitre des épisodes de paranoïa en suspectant leur entourage ou les instances gouvernementales. Au niveau physique, le syndrome de Paris s'exprime par des palpitations cardiaques, une sensation de vertige, un phénomène de sudation inhabituel et un sentiment d'oppression très fort. Bien qu'il ne figure pas dans le référentiel psychiatrique du DSM-5, le syndrome de Paris est généralement reconnu par les médecins après observation clinique et exclusion d'autres troubles psychiques. Certains profils sont plus à risque comme les touristes qui idéalisent beaucoup la ville de Paris, ceux qui proviennent de pays lointains ou de cultures très différentes. Les voyageurs seuls et ceux ayant des antécédents de troubles mentaux font aussi partie des personnes plus sensibles à ce syndrome. Qu'est-ce qui cause ou déclenche le syndrome de Paris ? À l'étranger, et plus précisément dans les pays asiatiques comme le Japon ou la Chine, Paris est présentée comme la ville du romantisme, de la mode et du raffinement. Les touristes s'en font une idée à travers des médias qui fantasment la capitale française. Lorsqu'ils décident de visiter Paris, ils formulent des attentes irréalistes qui devraient transcender leur quotidien. Confrontés à la réalité de la vie parisienne, sa foule, sa pollution, ses problèmes sociaux et son rythme de vie incessant, certains visiteurs subissent alors une désillusion profonde et rapide. La confrontation entre leur idéal et ce qu'ils vivent occasionne un choc psychologique traumatisant. Les facteurs qui aggravent le risque de syndrome de Paris sont le stress du voyage, le décalage horaire, la barrière de la langue, la fatigue et le sentiment de perte des repères habituels. La solitude de l'expatrié contribue aussi à favoriser la survenue de ce trouble. Résolution du syndrome de Paris La thérapie cognitivo-comportementale, dite TCC, est l'intervention psychologique la plus adaptée pour aider les patients à restructurer leurs pensées et leurs attentes. Lorsque le syndrome est sévère, un psychiatre peut prescrire des anxiolytiques ou des antipsychotiques en complément de la thérapie. Pour prévenir le syndrome de Paris, il est conseillé aux touristes de bien préparer leur séjour en utilisant des sources fiables et réalistes, et de s'imprégner au maximum de la culture, par exemple en apprenant la langue du pays avant le voyage. Learn more about your ad choices. Visit megaphone.fm/adchoices

Kimberley: Welcome, everybody. This is a very exciting episode. I know I'm going to learn so much. Today, we have Caitlin Pinciotti and Shala Nicely, and we're talking about when OCD and PTSD collide and intertwine and how that plays out. This is actually a topic I think we need to talk about more. Welcome, Caitlin, and welcome, Shala. Caitlin: Thank you. Shala: Thanks. Kimberley: Okay. Let's first do a little introduction. Caitlin, would you like to go first introducing yourself? Caitlin: Sure thing. I'm Caitlin Pinciotti. I'm a licensed clinical psychologist and an assistant professor in the Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine. I also serve as a co-chair for the IOCDF Trauma and PTSD and OCD SIG. If people are interested in that special interest group as well, that's something that's available and up and running now. Most of my research specifically focuses on OCD, trauma, and PTSD, and particularly the overlap of these things. That's been sort of my focus for the last several years. I'm excited to be here and talk more about this topic. Kimberley: Thank you. You're doing amazing work. I've loved being a part of just watching all of this great research that you're doing. Shala, would you like to introduce yourself? Shala: Yes. I'm Shala Nicely. I am a licensed professional counselor, and I specialize in the treatment of OCD and related disorders. I am the author of Is Fred in the Refrigerator?: Taming OCD and Reclaiming My Life, which is my story, and then co-author with Jon Hershfield of Everyday Mindfulness for OCD: Tips, Tricks, and Skills for Living Joyfully. I also produce the Shoulders Back! newsletter. It has tips and resources for taming OCD. Kimberley: Shoulders Back! was actually the inspiration for this episode. Shala, you recently wrote an article about post-traumatic OCD or how PTSD and OCD collide. Can you tell us about your story, particularly going back to, I think you mentioned, May 2020, and what brought you to write that article? Shala: Sure, and thank you very much for having Caitlin and me on today because I really appreciate the opportunity to talk about this and to get more information out in the world about this intertwined combination of PTSD and OCD. In May of 2020, I moved to a new house, the house that I'm in now. Of course, we had just started the pandemic, and so everybody was working at home, including me. The house that I moved into was in a brand new neighborhood. While the houses on this side of me were completed, the houses behind me and on that side were not completed. I didn't think anything of that when I moved in. But what I moved into was a situation where I was in a construction zone all the time. I was working at home, so there was no escape from it. One day I was walking behind my house, where most of the houses were in the process of being built and there were no sidewalks. As I was walking down the street, I saw, down at the end of the street, a big forklift come down the street where I was walking with my two little dogs backwards at a really high rate of speed, and the forklift driver seemed to be looking that way, and he was going that way. It happened so fast because he was going so quickly that all of a sudden I realized he was going to hit us, my dogs and me, and there was no place for us to go because we were on the road because there was nowhere else for us to be. I screamed bloody murder, and he heard me. I mean, that's how loud I screamed, and he stopped. That was not all that pleasant. I was upset. He was not happy. But we moved on. But my brain didn't move on.  After that incident, what I noticed was I was becoming really hypervigilant in my own house and finding the construction equipment. If I go outside, I tense up just knowing that construction equipment is there. Over time, my sleep started becoming disturbed. I started to have flashbacks and what I call flash-forwards, where I would think about all these horrible things that could happen to me that hadn't happened to me yet but could. I'd get lost in these violent fantasies of what might happen and what I need to do to prevent that.  I realized that I seemed to be developing symptoms of PTSD. This is where being a therapist was actually quite helpful because I pulled the DSM open one night and I started going through symptoms of PTSD. I'm like, “Oh my gosh, I think I have PTSD.”  I think what happened, because having a forklift driver almost hit you, doesn't seem like that could possibly cause PTSD. But if you look at my history, I think that created a link in my brain to an accident I was in when I was four where I did almost die, which is when my mom and I were standing on the side of a road, about to cross. We were going to go between two parked cars. My mom and I stepped between two parked cars, and there was a man driving down the road who was legally blind, and he mistook the line of parked cars where we were standing as moving traffic. He plowed into the end of all the parked cars, which of course made them accordion in, and my mom and I were in the middle of that. I was very seriously injured and probably almost died. My mom was, too. Several months in the hospital, all of that.  Of course, at that point—that was 1975—there was no PTSD, because I think— Caitlin, you can correct me—it didn't become a diagnosis until 1980. I have had symptoms—small, low-level symptoms of PTSD probably on and off most of my life, but so low-level, not diagnosable, and not really causing any sort of problems. But I think what happened in my head was that when that forklift almost hit me, it made my brain think, “Oh my gosh, we're in that situation again,” because the forklift was huge. It was the same scale to me as an adult as that car that I was crushed between was when I was four. I think my brain just got confused. Because I was stuck with this construction equipment all day long and I didn't get any break from it, it just made my brain think more and more and more, “Boy, we are really in danger.” Our lives are basically threatened all the time.  That began my journey of figuring out what was going on with me and then also trying to understand why my OCD seemed to be getting worse and jumping in to help because I seemed to get all these compulsions that were designed to keep me safe from this construction equipment. It created a process where I was trying to figure out, "What is this? I've got both PTSD now, I've got OCD flaring up, how do I deal with this? What do I do?" The reason why I wanted to write the article for Shoulders Back! and why I asked Caitlin to write it with me was because there just isn't a lot of information out there about this combination where people have PTSD or some sort of trauma, and then the OCD jumps in to help. Now you've got a combination of disorders where you've got trauma or PTSD and OCD, and they're merging together to try to protect you. That's what they think they're doing. They're trying to help you stay safe, but really, what they're doing is they're making your life smaller and smaller and smaller.  I wanted to write this article for Shoulders Back! to let people know about my experience so that other people going through this aren't alone. I wanted to ask Caitlin to write it with me because I wanted an expert in this to talk about what it is, how we treat it, what hope do we have for people who are experiencing this going forward. THE DIFFERENCE BETWEEN OCD AND PTSD (AND POST-TRAUMATIC OCD)  Kimberley: Thank you for sharing that. I do encourage people; I'll link in the show notes if they want to go and read the article as well. Caitlin, from a clinical perspective, what was going on for Shala? Can you break down the differences between OCD and PTSD and what's happening to her? Caitlin: Sure. First, I want to start by thanking Shala again for sharing that story. I know you and I talked about this one-on-one, but I think really sharing personal stories like that obviously involves a lot of courage and vulnerability. It's just so helpful for people to hear examples and to really resonate with, “Wow, maybe I'm not so different or so alone. I thought I was the only one who had experiences like this.” I just want to publicly thank you again for writing that blog and being willing to share these really horrible experiences that you had.  In terms of how we would look at this clinically, it's not uncommon for people to, like Shala described, experience trauma and have these low-level symptoms for a while that don't really emerge or don't really reach the threshold of being diagnosable. This can happen, for example, with veterans who return home from war, and it might not be until decades later that they have some sort of significant life event or change. Maybe they've retired, or they're experiencing more stress, or maybe, like Shala, they're experiencing another trauma, and it just brings everything up. This kind of delayed onset of PTSD is, for sure, not abnormal.  In this case, it sounds like, just like Shala described, that her OCD really latched onto the trauma, that she had these experiences that reinforced each other. Right now, I've had two experiences where being around moving vehicles has been really dangerous for me. Just like you said, I think you did such a beautiful job of saying that the OCD and PTSD colluded in a way to keep you “safe.” That's the function of it. But of course, we know that those things go to the extreme and can make our lives very small and very distressing.  What Shala described about using these compulsions to try to prevent future trauma is something that we see a lot in people who have comorbid OCD and PTSD. We're doing some research now on the different ways that OCD and trauma can intersect. And that's something that keeps coming up as people say, “I engaged in these compulsions as a way to try to prevent the trauma from happening to me again or happening to someone else. Or maybe my compulsions gave me a sense of control, predictability, or certainty about something related to the trauma.” This kind of presentation of OCD sort of functioning as protection against trauma or coping with past trauma as well is really common. STATISTICS OF OCD AND PTSD Kimberley: Would you share a little bit about the statistics between OCD and PTSD and the overlap? Caitlin: Absolutely. I'm excited to share this too, because so much of this work is so recent, and I'm hopeful that it's really going to transform the way that we see the relationships between OCD and PTSD. We know that around 60% of people who have comorbid OCD and PTSD tend to have an experience where PTSD comes first or at the same time, and the OCD comes later. This is sort of that post-traumatic OCD presentation that we're talking about and that Shala talked about in her article.  For folks who have this presentation where the PTSD comes first and then the OCD comes along afterwards, unfortunately, we see that those folks tend to have more severe obsessions, more severe compulsions. They're more likely to struggle with suicidality or to have comorbid agoraphobia or panic disorders. Generally speaking, we see a more severe presentation when the OCD comes after the PTSD and trauma, which is likely indicative of what we're discussing, which is that when the OCD develops as a way to cope with trauma, it takes on a mind of its own and can be really severe because it's serving multiple functions in that way. What we've been finding in our recent research—and if folks want to participate, the study will still be active for the next month; we're going to end it at the end of the year, the OCD and Trauma Overlap Study—what we're finding is that of the folks who've participated in the study, 85% of them feel like there's some sort of overlap between their OCD and trauma. Of course, there are lots of different ways that OCD and trauma can overlap.  I published a paper previously where we found that about 45% of people with severe OCD in a residential program felt that a traumatic or stressful event was the direct cause of their OCD on setting. But beyond that, we know that OCD and trauma can intersect in terms of the content of obsessions, the function of compulsions, as we've been talking about here, core fears. Some folks describe this, and Shala described this to this, like cyclical relationship where when one thing gets triggered, the other thing gets triggered too.  This is really where a lot of the research is focusing on now, is how do these things intersect, how often do they intersect, and what does that really look like for people? Kimberley: Thanks. I found in my practice, for people who have had a traumatic event, as exactly what happened to Shala, and I actually would love for both of you maybe to give some other examples of how this looks for people and how it may be experienced, is let's say the person that was involved in the traumatic event or that place that the traumatic event was recent that recently was revisited just like Shala. Some of them go to doing safety behaviors around that person, place, or event, or they might just notice an uptick in their compulsions that may have completely nothing to do with that. Shala, can you explain a little bit about how you differentiated between what are PTSD symptoms versus OCD, or do you consider them very, very similar? Can you give some insight into that? SYMPTOMS OF OCD & PTSD  Shala: Sure. I'll give some examples of the symptoms of OCD that developed after this PTSD developed, but it's all post-traumatic OCDs. I consider it to be different from PTSD, but it is merged with PTSD because it's only there because the PTSD is there.  For instance, I developed a lot of checking behaviors around the doors to my house—staring, touching, not able to just look once before I go to bed, had to be positively sure the doors were locked, which, as somebody who does this for a living, who helps people stop doing these compulsions, created a decent amount of shame for me too, as I'm doing these compulsions and saying, “Why am I not taking my own advice here? Why am I getting stuck doing this?”  But my OCD thought that the construction equipment was outside; we're inside. We need to make sure it stays outside. The only way we do that is to make sure the door stays locked, which is ridiculous. It's not as if a forklift is going to drive through my front door. As typical with OCD, the compulsions don't make a lot of sense, but there's a loose link there. Another compulsion that I realized after a time was probably linked with PTSD is my people-pleasing, which I've always struggled with. In fact, Kimberley, you and I have done another podcast about people-pleasing, something I've worked really hard on over the years, but it really accelerated after this. I eventually figured out that that was a compulsion to keep people liking me so that they wouldn't attack me. That can be an OCD compulsion all by itself, but it was functioning to help the PTSD.  Those would be two examples of compulsions that could be OCD compulsions on their own, but they would not have been there had the PTSD not been there. Kimberley: Caitlin, do you want to add anything about that from symptoms or how it might look and be experienced? Caitlin: Sure, yeah. I think it's spot on that there's this element of separation that we can piece apart. This feels a little bit more like OCD; this feels a little bit more like PTSD, but ultimately they're the same thing, or it's the same behavior.  In my work, I usually try to, where I can, piece things apart clinically so that we can figure out what we should do with this particular response that you're having. When it comes to differentiating compulsions, OCD compulsions and PTSD safety behaviors, we can look towards both the presentation of the behavior as well as the function of it.  In terms of presentation, I mean, we all know what compulsions can look like. They can be very rigid. There can be a set of rules that they have to be completed with. They're often characterized by a lot of doubting, like in Shala's case, the checking that, “Well, okay, I checked, but I'm not actually sure, so let me check one more time.” Whereas in PTSD, although it's possible for that to happen, those safety behaviors, usually, it's a little bit easier to disengage from. Once I feel like I've established a sense of safety, then I feel like I can disengage from that. There doesn't tend to be kind of that like rigidity and a set of rules or magical thinking that comes along with an OCD compulsion.  In terms of the function, and this is where it gets a little bit murky with post-traumatic OCD, broadly speaking, the function of PTSD safety behaviors is to try to prevent trauma from occurring again in the future. Whereas OCD compulsions, generally speaking, are a way to obtain certainty about something or prevent some sort of feared catastrophe related to someone's obsession. But of course, when the OCD is functioning along with the PTSD to cope with trauma, to prevent future trauma, that gets a little bit murkier.  In my work, like I said, I try to piece apart, are there elements of this that we can try to resist from more of an ERP OCD standpoint? If there's a set of rules or a specific way that you're checking the door, maybe we can work on reducing some of that while still having that PTSD perspective of being a little bit more lenient about weaning off safety behaviors over time. TREATMENT FOR OCD AND PTSD Kimberley: It's a perfect segue into us talking about the treatment here. Caitlin, could you maybe share the treatment options for these conditions, specifically post-traumatic OCD, but maybe in general, all three? Caitlin: Absolutely. The APA, a few years back, reviewed all the available literature on PTSD treatments, and they created this hierarchy of the treatments that have the most evidence base and went down from there. From their review of all the research that's been done, there were four treatments that emerged as being the most effective for PTSD. That would be broadly cognitive behavioral therapy and cognitive therapy. But then there are two treatments that have been specifically created to target PTSD, and that would be prolonged exposure or PE, and cognitive processing therapy or CBT. These all fall under the umbrella of CBT treatments, but they're just a little bit more specific in their approach. And then, of course, we know of ACT and EMDR and these other treatments that folks use as well. Those fall in the second tier, where there's a lot of evidence that those work for folks as well, but that top tier has the most evidence.  These treatments can be used in combination with OCD treatments like ERP. There are different ways that folks can combine them. They can do full protocols of both. They could borrow aspects of some treatments, or they could choose to focus really on if there's a very clear primary diagnosis to treat that one first before moving on to the secondary diagnosis. TREATMENT EXAMPLES FOR POST-TRAUMATIC OCD Kimberley: Amazing. Shala, if you're comfortable, can you give some examples of what treatment looked like for you and what that was like for you both having OCD and PTOCD?  Shala: Yes, and I think to set the ground for why the combined treatment working on the PTSD and the OCD together can be so important, a couple of features of how all this was presenting for me was the shift in the focus of the uncertainty. With OCD, it's all about an intolerance of uncertainty and not knowing whether these what-ifs that OCD is getting stuck on are true or going to happen. But what I noticed when I developed PTSD and then the OCD came in to help was that the focus of the uncertainty shifted to it's not what if it's going to happen. The only what-if is when it was going to happen because something bad happening became a given.  The uncertainty shifted to only when and where that bad thing was going to happen, which meant that I had lower insight. I've always had pretty good insight into my OCD, even before I got treatment. Many people with OCD too, we know what we're doing doesn't make any sense; we just can't stop doing it. With this combined presentation, there was a part of me that was saying, “Yeah, I really do need to be staring at the door. This is really important to make sure I keep that construction equipment out.” That lowered insight is a feature of this combined presentation that I think makes the type of treatment that we do more important, because we want to address both of the drivers, both the PTSD and the OCD. The treatment that I did was in a staged process. First, I had to find a treatment provider, and Caitlin has a wonderful list of evidence-based treatment providers who can provide treatment for both on her website, which is great. I found somebody actually who ended up being on Caitlin's list and worked with that person, and she wanted to start out doing prolonged exposure, which I pushed back on a little bit. Sometimes when you're a therapist and you're being the client, it's hard not to get in the other person's chair. But I pushed back on that because I said, “Well, I don't think I need to do prolonged exposure on the original accident,” because that's what she was suggesting we do, the accident when I was four. I said, “Because I wrote a book, Is Fred in the Refrigerator? and the very first chapter is the accident,” and I talked all about the accident. She explained, “That's a little bit different than the way we would do it in prolonged exposure.” What's telling, I think, is that when I worked on the audiobook version of Fred—I was doing the narration, I was in a studio, and I had an engineer and a director; they were on one side of the glass, I'm on the other side of the glass—I had a really hard time getting through that first chapter of the book because I kept breaking down. They'd have to stop everything, and I had to get myself together, and we had to start again, and that happened over and over and over again.  Even though I had relived, so to speak, this story on paper, I guess that was the problem. I was still reliving it. That's probably the right word. Prolonged exposure is what I needed to do because I needed to be able to be in the presence of that story and have it be a story in the past and not something that I was experiencing right then.  I started with prolonged exposure. After I did that, I moved on to cognitive processing therapy because I had a lot of distorted beliefs around life and the trauma that we call “stuck points” in cognitive processing therapy that I needed to work through. There were a good 20 or so stuck-point beliefs. “If I don't treat people perfectly nicely, they're going to attack me somehow.” Things that could be related directly to the compulsions, but also just things like, “The world is dangerous. If I'm not vigilant all the time, something bad is going to happen to me.” I had to work on reframing all of those because I was living my life based on those beliefs, which was keeping the trauma going.  I recreated a new set of beliefs and then brought exposure in to work on doing exposures that helped me act as if those new beliefs were the right way to live. If my stuck point is I need to be hypervigilant because of the way something bad is going to happen to me, and I'm walking around like this, which was not an exaggeration of really how I was living my life when this was all happening—if I'm living like that, if I'm acting in a hypervigilant way, I am reinforcing these beliefs. I need to go do exposures where I can walk by a dump truck without all the hypervigilance to let all that tension go, walk by it, realize what I've learned, and walk by it again.  It was a combination of all these and making sure that I was doing these exposures, both to stop the compulsions I was doing, like the door checking, but also to start living in a different way so that I wasn't in my approach to life, reinforcing the fact that my PTSD thought the world was dangerous.  I also incorporated some DBT (dialectical behavior therapy) because what I found with this combination was I was experiencing a lot more intense emotions than I'd really ever experienced in having OCD by itself. With OCD, it was mostly just out-of-this-world anxiety, but with the combination of PTSD and OCD, there were a lot more emotional swings of all sorts of different kinds that I needed to learn and had to deal with. Part of that too was just learning how to be in the presence of these PTSD symptoms, which are very physiological. Not like OCD symptoms aren't, but they tend to be somewhat more extreme, almost panicky-like feelings. When you're in the flashbacks or flash forwards, you can feel dissociated, and you're numbing out and all of that. I'm learning to be in the presence of those symptoms without reacting negatively to them, because if I'm having some sort of feelings of hypervigilance that are coming because I'm near a piece of construction equipment and I haven't practiced my ERP (Expsoure & Response Prevention) for a while, if I react negatively and say, “Oh my gosh, I shouldn't be having these symptoms. I've done my therapy. I shouldn't be having these feelings right now,” it's just going to make it worse. Really, a lot of this work on the emotional side was learning how to just be with the feelings. If I have symptoms, because they happen every now and then—if I have symptoms, then I'm accepting them. I'm not making them worse by a negative reaction to the reaction my PTSD is having.  That was a lot of the tail end of the work, was learning how to be okay with the fact that sometimes you're going to have some PTSD symptoms, and that's okay. But overreacting to them is going to make it worse.  Kimberley: Thank you so much for sharing that. I just want to maybe clarify for those who are listening. You talked about CPT, you talked about DBT, and you also talked about prolonged exposure. In the prolonged exposure, you were exposing yourself to the dump truck? Is that correct? Shala: In the prolonged exposure, I was doing two different things. One is the story of the accident that I was in. Going back to that accident that I thought I had fully habituated to through writing my book and doing all that, I had to learn how to be in the presence of that story without reliving it while seeing it as something that happened to me, but it's not happening to me right now. That was the imaginal part of the prolonged exposure.  This is where the overlap between the disorders and the treatment can get confusing of what is part of what. You can do the in vivo exposure part of prolonged exposure. Those can also look a lot like just ERP for OCD, where we're going and we're standing beside a dump truck and dropping the hypervigilant safety behaviors because we need to be able to do that to prove to our brain we can tolerate being in this environment. It isn't a dangerous environment to stand by a jump truck. It's not what happened when I was four. Those are the two parts that we're looking at there—the imaginal exposure, which is the story, and then we've got the in vivo exposures, which are going back and being in the presence of triggers, and also from an OCD perspective without compulsive safety behaviors. Kimberley: Amazing. What I would clarify, but please any of you jump in just for the listeners, if this is all new to you, what we're not saying is, let's say if there was someone who was abusive to you as a child, that you would then expose yourself to them for the sake of getting better from your PTSD. I think the decisions you made on what to expose yourself were done with a therapist, Shala? They helped you make those decisions based on what was helpful and effective for you? Do either of you want to speak to what we do and what we don't expose ourselves to in prolonged exposure? Caitlin: Yeah. I'm glad that you're clarifying that too, because this is a big part of PE that is actually a little bit different from ERP. When somebody has experienced trauma, when they have PTSD, their internal alarm system just goes haywire. Just like in Shala's example, anything that serves as a reminder or a trigger of the trauma, the brain just automatically interprets as this thing is dangerous; I have to get away from it.  In PE, a lot of what we're doing is helping people to recalibrate that internal alarm system so that they can better learn or relearn safe versus actual threat. When you're developing a hierarchy with someone in PE, you might have very explicit conversations about how safe is this exposure really, because we never want to put someone in a situation where they would be unsafe, such as, like you described, interacting with an abuser.  In ERP, we'd probably be less likely to go through the exposures and say, “This one's actually safe; I want you to do it,” because so much of the treatment is about tolerating uncertainty about feared outcomes. But in PE, we might have these explicit conversations. “Do other people you know do this activity or go to this place in town?” There are probably construction sites that wouldn't be safe for Shala to go to. They'd be objectively dangerous, and we'd never have her go and do things that would put her in harm's way. Kimberley: Thank you. I just wanted to clarify on that, particularly for folks who are hearing this for the first time. I'm so grateful that we're having this conversation again. I think it's going to be so eye-opening for people. Caitlin, can you share any final words for the listeners? What resources would you encourage them to listen to? Is there anything that you feel we missed in our conversation today for the listeners? Caitlin: I think, generally, I like to always leave on a note of hope. Again, I'm so grateful that Shala is here and gets to describe her experience with such vulnerability because it gives hope that you can hear about someone who was at their worst, and maybe things felt hopeless in that moment. But she was able to access the help that she needed and use the tools that she had from her own training too, which helped, and really move through this.  There isn't sort of a final point where it's like, “Okay, cool, I'm done. The trauma is never going to bother me again.” But it doesn't have to have that grip on your life any longer, and you don't need to rely on OCD to keep you safe from trauma.  There are treatments out there that work. Like it was mentioned, I have a directory of OCD and PTSD treatment providers available on my website, which is www.cmpinciotti.com that folks can access if they're looking for a therapist. If you're a therapist listening and you believe that you belong in this directory, there's a way to reach out to me through the website.  I'd also say too that if folks are willing and interested, participating in the research that's happening right now really helps us to understand OCD and PTSD better so that we can better support people. If you're interested in participating in the OCD and trauma study that I mentioned, you can email me at OCDTraumaStudy@bcm.edu. I also have another study that's more recent that will help to answer the question of how many people with OCD have experienced trauma and what are those more commonly endorsed ways that people feel that OCD and trauma intersect for them. That one's ultra-brief. It's a 10-minute really quick survey, NationalOCDSurvey@bcm.edu and I'm happy to share that anonymous link with you as well/ Kimberley: Thank you. Thank you so much. Shala, can you share any final words about your experience or what you want the listeners to hear? Shala: One thing I'd like to share is a mistake that I made as part of my recovery that I would love for other people not to make. I'd like to talk a little bit about that, because I think it could be helpful. The mistake that I made in trying to be a good client, a good therapy client, is I was micro-monitoring my recovery. “How many PTSD symptoms am I having? Well, I'm still having symptoms.” I woke up in the middle of the night in a panic, or I had a bad dream, or I had a flash forward. “Why am I having this? I must not be doing things right.” And then I took it a step further and said, “It would be great if I could track the physiological markers of my PTSD so I can make sure I'm keeping them under control.” I got a piece of tracking technology that enabled me to track heart rate and heart rate variability and sleep and all this stuff. At first, it was okay, but then the technology that I was using changed their algorithm, and all of a sudden my stats weren't good anymore, and I started freaking out. “Oh my gosh, my sleep is bad. My atrophy is going down. This is bad. What am I doing?” I was trying with the best of intentions to quantify, make sure I'm doing things right, focus on recovery. But what I was doing was focusing on the remaining symptoms that were there, and I was making them worse.  What I have learned is that eventually, things got so bad—in fact, with my sleep—that I got so frustrated with the tracking technology. I said, “I'm not wearing it anymore.” That's one of the things that helped me realize what I was doing. When I stopped tracking my sleep, when I let go of all of this and said, “You know what? I'm going to have symptoms,” things got better.  I would encourage people not to overthink their recovery, not to be in their heads and wake up in the morning and ask, “How much PTSD am I having? How much OCD am I having? If I could just get rid of these last little symptoms, life would be great,” because that's just going to keep everything going.  I'll say this year, two has been a challenging one for me. I've been involved in three car accidents this year; none of them my fault. One of my neighbors, whom I don't know, called the police on me, thinking I was breaking into my own house, which meant that a whole army of police officers ended up at my house at nine o'clock at night. That's four pretty hard trauma triggers for me in 2023.  Those kinds of things are going to happen to all of us every now and then. I had a lot of symptoms. I had a lot of PTSD symptoms and a lot of OCD symptoms in the wake of those events, and that's okay. It's not that I want them to be there, but that's just my brain reacting. That's my brain trying to come to terms with what happened and how safe we are and trying to get back to a level playing field.  I think it's really important for anybody else out there who's suffering from one or the other, or both of these disorders to recognize we're going to have symptoms sometimes. Just like with OCD, you're going to have symptoms sometimes. It's okay. It's the pushing away. It's the rejecting of the symptoms. It's the shaming yourself for having the symptoms that causes the symptoms to get worse.  Really, there is an element of self-compassion for OCD here. I like having bracelets to remind me. This is the self-compassion bracelet that I've had for years that I wear. By the way, this is not the tracking technology. I'm not using tracking technology anymore. But remembering self-compassion and telling yourself, “I'm having symptoms right now, and this is really hard. I'm anxious; I feel a little bit hypervigilant, but this is part of recovery from PTOCD. Most people with PTOCD experience this at some point. So I'm going to give myself a break, give myself permission to feel what I'm feeling, recognize how much progress I've made, and, when I feel ready, do some of my therapy homework to help me move past this, but in a nonhypervigilant, nonmicro monitoring way.” As I have dropped down into acceptance of these symptoms, my symptoms have gotten a lot better. I think that's a really important takeaway. Yes, we want to work hard in our therapy, yes, we want to do the homework, but we also want to work on accepting because, in the acceptance, we learn that having these symptoms sometimes is just a part of life, and it's okay.  I would echo what Caitlin said in that you can have a ton of hope if you have these disorders, in that we have good treatment. Sometimes it takes a little bit longer than working on either one or the other, but that makes sense because you're working on two. But we have good treatment, and you can get back to living a joyful life.  Always have hope and don't give up, because sometimes it can be a long road, especially when you have a combined presentation. But you can tame both of these disorders and reclaim your life. Kimberle: You guys are so good. I'm so grateful we got to do this. I feel like it's such an important conversation, and both of you bring such wonderful expertise and lived experience. I'm so grateful. Thank you both for coming on and talking about this with me today. I'm so grateful. Shala: Thank you for having us. Caitlin: Yes, thank you. This was wonderful. Kimberley: Thank you so much, guys. RESOURCES:  The two studies CAITLIN referenced are: OCD/Trauma Overlap Study: An anonymous online survey for any adult who has ever experienced trauma, and can be accessed at https://bcmpsych.sjc1.qualtrics.com/jfe/form/SV_0j4ULJv3DxUaKtE or by emailing OCDTraumaStudy@bcm.edu National OCD Survey: An anonymous 10-minute online survey for any U.S. adult who has ever had OCD, and can be accessed at https://bcmpsych.sjc1.qualtrics.com/jfe/form/SV_9LdbaR2yrj0oV7g or by emailing NationalOCDSurvey@bcm.edu

Você está no canal de Podcast O Marketeiro. O tema: Métricas para Avaliar Negócios de Impacto Positivo na Sociedade: Medindo o Sucesso Além dos Lucros Neste episódio, você terá a oportunidade de explorar o emocionante mundo dos negócios de impacto positivo na sociedade e aprender como medir e comunicar seu sucesso além dos lucros. Junte-se a nós para uma conversa esclarecedora com um especialista em negócios sociais e métricas de impacto, que compartilhará sua experiência e conhecimentos para inspirar marqueteiros e empreendedores a adotar métricas de impacto eficazes e promover negócios que façam a diferença no mundo. Prepare-se para descobrir como a medição do impacto pode ser uma ferramenta poderosa para impulsionar o sucesso de negócios com propósito social e ambiental. (*) José Mattos: Psicólogo Social, mestre em análise de políticas públicas e descentralização da governança pela universidade de Coimbra, com 26 anos atuando como especialista em desenvolvimento local e empreendedorismo de impacto. Diretor do Capítulo Brasil da Rede de Empreendedores ANDE do Instituto Aspen. Fundador da ViaFloresta, um hub de soluções estratégicas em sustentabilidade e ESG. Atuou na Natura&Co, VALE e liderou projetos na HYDRO, Nestlé, Dow, DSM, Mane e IFF. Foi diretor Administrativo da Agência de Defesa Agropecuária do Estado do Pará e técnico da Secretaria de Estado de Meio Ambiente e Sustentabilidade. Foi membro do GT de Direito Humanos do Pacto Global Brazil e relator da NDC empresarial pelo Instituto Ethos, além de consultor do Instituto Arapyaú e advisor do CEBDS. É, também, gestor no Fórum Amazônia Sustentável, um espaço tripartite que discute e atua na melhoria da qualidade de vida na Amazônia. Professor de MBA na Puc-PR, palestrante e conselheiro de ONGs. Até o próximo Podcast!

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* Mets-toi en présence de Dieu, pour essayer de Lui parler. * Tu disposes de 10 minutes, pas plus : va jusqu'au bout, même si tu te distrais. * Persévère. Prends ton temps et laisse l'Esprit Saint agir 'à petit feu'. Un passage de l'Évangile, une idée, une anecdote, un prêtre qui s'adresse à toi et au Seigneur, et t'invite à entrer dans l'intimité de Dieu. Choisis le meilleur moment, imagine que tu es avec Lui, et appuie sur play pour commencer. Toutes les infos sur notre site : www.10minutesavecjesus.org Contact : 10minavecjesus@gmail.com DSM

Jörgen Herlofson är legitimerad läkare, specialist i psykiatri, legitimerad psykoterapeut och förestår DSM i Sverige. Jörgen är förutom detta även föreläsare, författare, engagerad i utbildning och nu aktuell i en nationell expertgrupp gällande utmattningssyndrom. Marie Åsberg är legitimerad läkare, psykiatriker och professor emeritus vid Karolinska Institutet (KI). Marie har under sin karriär framför allt arbetat med behandlingsforskning och är kanske främst känd för framtagandet av det så kallade ”Montgomery-Åsberg Depression Rating Scale (MADRS), en skattnings skala för framför allt depressionssymptom. Marie disputerade 1973 på en avhandling om depressionsbehandling med läkemedlet Nortriptylin och undersökte sen olika biomarkörer för depression och fann en koppling mellan låga nivåer av seratonin och självmord. 1982 utnämndes hon till professor i psykiatri vid KI och senare i början av 1990-talet var hon med och införde dialektisk beteende terapi, den så kallade DBT terapi för att hjälpa framför allt patienter med borderline problematik/instabil personlighetsstörning. Förutom allt detta är även Mari känd för införandet av diagnosen utmattningssyndrom, vilket också är anledningen till dagens samtal tillsammans med dr. Jörgen Herlofson. Dagens avsnitt är ett av två, där lyssnaren får vara med om ett unikt samtal mellan två av Sveriges giganter i psykiatri, denna gång gällande diagnosen Utmattningssyndrom. Tack för att just du lyssnar på ”Både och, istället för antingen eller – en podd om Integrativ medicin och hälsa. Följ oss på sociala medier, och ge oss gärna fem stjärnor på iTunes om det här var givande för dig. Prenumerera gärna på vår podd! ♥ Facebook: https://www.facebook.com/integrativmedicin ♥ Youtube: https://www.youtube.com/user/integrativMedicin

In this episode, Laura Petix interviews Casey Ehrlich, a social scientist and expert in Pathological Demand Avoidance (PDA). Casey shares her personal story of discovering her son's PDA diagnosis and journey to understanding. She discusses PDA as a dysregulated nervous system perceiving threats to autonomy. Casey provides 5 key accommodation strategies for supporting PDA needs, including letting kids win games, using declarative language, strewing for engagement, letting go of demands for "please" and "thank you", and allowing kids to opt out. Laura asks challenging questions and Casey explains how to apply accommodations thoughtfully. Parents will learn practical ways to connect with their PDA kids through an autonomy-focused lens. This episode is invaluable for anyone seeking to understand and support the unique needs of children with Pathological Demand Avoidance.About the expert: Casey Ehrlich, Ph.D. (she/her) is a social scientist, parent educator, and the founder of At Peace Parents, LLC. Casey brings 15 years of work experience and expertise in social science methodology to help parents and therapists understand how to connect with and accommodate PDA Autistic children. She specializes in teaching parents and therapists practical skills in the home or clinical setting to accommodate neuroception-driven demand avoidance and nervous system differences through creative techniques. She has served more than 1,000 families raising PDA Autistic children and teens since 2020 and is also raising a PDA autistic son.Questions we cover: What is PDA?What is like parenting a child with PDA? What are the best ways to accommodate a child with PDA? What are some resources to look further into PDA? Links: @atpeaceparents instagram PDA parents podcast https://www.pdaparents.com/podcast - Kristy Forbes- Neuroclastic- Neurodivergent Lou- Sally Cat (writes on the internalized expression of PDA)- PDA Society (for journal articles on research about PDA)- “The declarative language handbook”5 ways to accommodate a PDA child instagram post4 S's for regulation  in PDASensory Detectives Waitlist (next cohort: early 2024) Episode transcript: https://www.theotbutterfly.com/podcast The OT Butterfly Instagram: https://www.instagram.com/theotbutterfly Work with Laura: https://www.theotbutterfly.com/parentconsult Buy "A kids book about neurodiversity" : www.theotbutterfly.com/book

Shows Main Idea – There are two competing authorities in our culture today that present the pathway to transformation. The secular psychological community put forth the DSM as the authority to transform your life, while the Christian believes the Bible is the world's transcending, authoritative psychology book that brings peace and change to the soul. The one you choose will determine the course and quality of your life. Rick compares the two in this webinar while making a persuasive case for God's Word as the authority over our souls. Show Notes: https://lifeovercoffee.com/podcast/ep-488-webinar-our-competing-psychologies/ Will you help us to continue providing free content for everyone? You can become a supporting member here https://lifeovercoffee.com/join/, or you can make a one-time or recurring donation here https://lifeovercoffee.com/donate/.

This week VMware announced the latest release of VMware Data Services Manager (DSM), version 2.0. DSM enables the provisioning of data services (e.g., databases, object stores) on vSphere infrastructure. This release builds on earlier versions of VMware Data Services Manager 1.x, but also extends the product. On this episode of the Virtually Speaking Podcast Cormac Hogan shares the details of this new release.

To contact Michelle Minette... Email: maminette@mamchlc.com Website: f-allthat.com FB Page: https://www.facebook.com/michelleaminettechlc ⁠⁠⁠Website: www.clermontmentalhealth.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email: snap@clermontmentalhealth.care Text: 513-655-6101 ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube Channel⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram: @theofficialsnap FB Page: @mfriedmanlpcc ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SNAP FB Group⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter: @mfriedmanlpcc Mandy Friedman, LPCC-S, CCDVC, CCTP-II, CCMHC is a Licensed Professional Clinical Counselor, a Certified Clinical Domestic Violence Counselor, a Clinically Certified Trauma Professional and a Certified Clinical Mental Health Counselor. Mandy is the creator of the educational recovery program SNAP: Survivors of Narcissistic & Abusive Personalities. This program teaches survivors and concerned loved ones about abusive personalities, targets of abuse, abusive relationships and life in recovery from abuse. SNAP educational program of recovery helps empathic survivors of abuse fine tune and connect with their empathic nature in order to preserve, harness and protect the very things abusers seek to destroy. In her private practice, Clermont Mental Health, Mandy specializes in treating survivors of Cluster B personalities. She is also familiar with the role of addiction, substance abuse and self-harm in abusive relationships. Mandy's clients are often in need of trauma-informed care as part of their recovery. This has led her to specialize treating clients with Complex Post Traumatic Stress Disorder (C-PTSD). To help her clients, Mandy utilizes mindfulness based cognitive therapy (MBCT), cognitive behavioral therapy (CBT), psychoeducation and Polyvagal Theory. Mandy is a survivor of abuse and has first-hand knowledge of what survivors endure in abusive circumstances and living a healthy life after abuse. Disclaimer: This content is intended for educational purposes only. It is not a substitute for mental health treatment. It is important for survivors of abuse to find mental health professionals who understand trauma and abusive relationships. Please seek support from trusted and trained practitioners. This content is not meant to be used by anyone as diagnostic criteria. Permissions have not been granted for anyone to utilize this material as a source to make allegations about specific individuals. Any online content produced by SNAP: Survivors of Narcissistic & Abusive Personalities, Clermont Mental Health or Mandy Friedman LPCC-S is an educational discussion about narcissism which is a descriptive term for tendencies and behavioral patterns. Individuals with narcissistic features or tendencies do not necessarily meet DSM diagnostic criteria. The terms narcissistic and narcissism are used as descriptions of tendencies and behaviors and are not meant as clinical terms. --- Support this podcast: https://podcasters.spotify.com/pod/show/mandy-friedman-lpcc/support

On this week's Military Life *Parents Edition* podcast episode, I speak with Spouse and Defence School Mentor Bianca about her new business, ‘Someone I Love is in Defence'. Bianca and I also spoke about; •         Her journey from being an ADF member herself, transitioning out & finding her feet as a Defence Partner •         Navigating Defence life, starting a family and deciding to take up a role as a Defence School Mentor •         How being a DSM opened her eyes to the need for more and  varied resources for Defence Kids •         Deciding to turn her ideas into activity sheets, colouring, activity and storybooks with specific themes for Australian Defence Kids •         Why the support of her Navy husband and FREE entrepreneur courses through the Prince's Trust and Frontline Labs were key to establishing and launching her business •         The importance of the resources serving a dual purpose- to be entertaining and also facilitate meaningful interactions •         How her activity sheets and books encourage conversations and Defence Kids to ask questions, express emotions, and strengthen their bond with their ADF member •         Focusing on a variety of Defence Life topics like moving, deployment, living apart from your ADF member (URF) and the transition out of Defence •         The importance of co-designing her resources and books with Defence Kids and parents •         How to access free resources via her website and when the activity books and Army, Navy, RAAF books will be available for purchase Follow Bianca on her ‘Someone I Love is in Defence' socials via the below links or sign up for her newsletter on her website https://www.someoneiloveisindefence.com.au/ to be the first to know when her colouring, activity and storybooks will be ready to purchase. Follow along on Facebook- https://www.facebook.com/someoneiloveisindefence Follow along on Instagram- https://www.instagram.com/someoneiloveisindefence

The significance of understanding employee physical and mental health and wellbeing has increased substantially in the hybrid world. Organizations are rethinking the importance of trust and autonomy in the employee experience to develop healthy, resilient and productive workforces for the long-term. Judith Wiese, chief people and sustainability officer at Siemens, joins the Talent Angle to discuss employee wellbeing and its implications for organizations. She highlights how Siemens' commitment to wellbeing and empowerment drives positive talent outcomes and positions the organization for sustainable success. Judith Wiese has been a member of the Managing Board of Siemens AG since October 1, 2020. She is the Chief People and Sustainability Officer as well as Labor Director for Siemens AG. In addition, Judith is responsible for Global Business Services (GBS) at Siemens. Judith has more than two decades of international experience in various HR fields. From 2017 to 2020, she was Chief Human Resources Officer at DSM, a Dutch company specializing in health, nutrition, and sustainable living. Before that, she worked for the U.S. food company Mars Inc., most recently as Head of People & Organization. *This episode is an excerpt taken from our 2022 interview.

This episode focuses on the internal experience of borderline personality dynamics, what it feels like.  Next, I share how “borderline” is a relatively new diagnosis, and previously indicated a range of personality development, rather than a specific disorder. I then discuss the standard diagnostic criteria from the DSM-5 and the Psychodynamic Diagnostic Manual, 2nd Ed., summarizing the symptoms in plain English. I explore the etiology or the origin of “borderline personality” and the underlying unmet attachment needs that fuel borderline dynamics. I describe different subtypes of borderline presentations and explore the types of partners to whom those with borderline dynamics are romantically attracted. From there, I describe five major treatment approaches and briefly discuss an outcome study. In closing, I review some suggestions for living with someone who presents with borderline characteristics.

I recently had an open discussion with my instagram audience on whether or not someone with a clinical diagnosis of anxiety would be considered neurodivergent. This stemmed from an inner conflict I was experiencing and trying to decide– am I neurodivergent? I actually shared a more in depth view of where I stand on this topic personally and it's in the previous episode, 88 if you want to go back and listen to that after this. This question brought up such great conversations in my DMs and I realized how nuanced this topic was, and how much I wanted to bring this discussion to a larger platform and to include different voices on the topic. So I reached out to some of my most respected peers in this space who all have some personal and professional tie to neurodiversity. I invited Dr. Cassidy Freitas (LMFT), Andi Putt (speech therapist) and Mr. Chazz (teacher of teachers and parenting coach) to join me for this round table episode. I asked questions like  What does the label of neurodivergent/ neurotypical do for people and societyif we classified too many mental health diagnoses as neurodivergent, would that “dilute” the meaning?If we include mental health diagnoses, it can seem like majority of the population would classify as neurodivergent, what does that mean for a "neurotypical" label if they are in the minority? Should you tell your child's teacher about their neurodiversity at the beginning of the school year?I asked them to weigh in on a thought someone shared with me that said “is anyone really neurotypical?”Links: Mr. Chazz InstagramMr. Chazz podcast episode: “Conscious Discipline with a ND child” Mr. Chazz podcast episode: “How to handle hitting with an OT” Mr. Chazz podcast epsiode: " Vestibular Processing with an OT" Dr. Cassidy InstagramDr. Cassidy podcast episode:” The trauma experience in parenthood”Dr. Cassidy podcast episode: “Raising a sensory sensitive child”Andi Putt InstagramAndi Putt podcast episode: “Celebrating Autism with a neurodiverse lens”Self-reflection episode on neurodiversitySensory Detectives Waitlist (next cohort: early 2024) Episode transcript: https://www.theotbutterfly.com/podcast The OT Butterfly Instagram: https://www.instagram.com/theotbutterfly Work with Laura: https://www.theotbutterfly.com/parentconsult Buy "A kids book about neurodiversity" : www.theotbutterfly.com/book

The renewable revolution is here. Scientists, entrepreneurs, and policymakers—including Indigenous and industry leaders—are accelerating the transition to clean energy. But does Canada unanimously agree on the path to a more sustainable future? Philippe Dunsky, founder of Dunsky Energy + Climate Advisors, joins thinkenergy to discuss. From climate counsels and regional challenges to greener business practices and how to positively impact the clean energy and climate sectors. Listen to Episode 124 today.   Related links   Philippe Dunsky on LinkedIn: https://www.linkedin.com/in/philippedunsky/  Dunsky Energy + Climate Advisors: https://www.dunsky.com/  Dunsky Energy + Climate Advisors on LinkedIn: https://www.linkedin.com/company/dunsky-energy-climate-advisors/ To subscribe using Apple Podcasts:  https://podcasts.apple.com/us/podcast/thinkenergy/id1465129405   To subscribe using Spotify: https://open.spotify.com/show/7wFz7rdR8Gq3f2WOafjxpl   To subscribe on Libsyn: http://thinkenergy.libsyn.com/ --- Subscribe so you don't miss a video: https://www.youtube.com/user/hydroottawalimited   Follow along on Instagram: https://www.instagram.com/hydroottawa   Stay in the know on Facebook: https://www.facebook.com/HydroOttawa Keep up with the posts on X: https://twitter.com/thinkenergypod ---- Transcript: Dan Seguin  00:06 This is think energy, the podcast that helps you better understand the fast changing world of energy through conversations with game changers, industry leaders, and influencers. So join me, Dan Seguin, as I explore both traditional and unconventional facets of the energy industry. Hey, everyone, welcome back. Right now, there are scientists, entrepreneurs, policymakers, indigenous and industry leaders, helping to shape the direction that Canada will take to accelerate a transition to clean energy. Everywhere you look, whether it's academia, municipal, provincial, or federal governments, there's another council or committee being formed to address the most pressing issues of our time, climate change, from transitioning to sustainable energy sources, electrifying transportation, and improving energy efficiency to protecting our natural environment and reducing carbon emissions. One thing is for certain our country is embracing the renewable revolution, like never before. But those with seats at the decision table know that it must be done responsibly, and affordable. As we know, every region of Canada is unique and presents its own set of challenges and opportunities when it comes to tackling climate change, and ways to implement clean energy. So here is today's big question. How did we get such a vast and diverse country like Canada to agree on a pathway forward to a cleaner, greener and more sustainable energy future? Joining us today is Philippe Dunsky of Dunsky Energy and Climate Advisors, a consultancy firm that Philippe founded. It supports government, utilities, corporations across North America to accelerate their transition to clean energy. Phillippe, is the co chair of Canada's new Canada electricity Advisory Council, the co chair of efficiency Canada, and the director of the greater Montreal Climate Fund. He also previously chaired the Quebec government electrification Working Group. Welcome to the show, Philippe. Let's start by asking you this. Having just gone over some of your accomplishments, where does this passion for clean energy and climate come from? Where did it start?   Philippe Dunsky  02:44 So, so great to be here. By the way, thank you so much for having me. It started, I guess, I guess very early on. I'm Jewish background and grew up with, you know, endless stories about the Holocaust. And somehow that kind of morphed into just a general  interest for world affairs and for big challenges, big societal challenges. And then as I was growing up, those became really focused on environmental issues. So that was the genesis. I became very, very interested in environmental issues. And then through that, and climate change in particular, as probably the greatest challenge of my generation, and for my generation. And then, I guess the other thing is, I've come to discover that I'm a pretty analytical guy. So I'm not a no great protester, I'm not a great to great movement leader, I tend to see a lot of gray, not so much black and white. And so that's how I ended up deciding to get involved in these issues. But, you know, in my own way through more of an analytical lens,   Dan Seguin  03:55 Okay, you've served and are serving on numerous councils, committees and boards. Can you tell us what has been the biggest takeaway you've learned through each collaboration? And how has it changed you?   Philippe Dunsky  04:11 Yeah, because each one does change you and changes your perspectives. Because ultimately, the biggest takeaway is that no matter how much I think I know this stuff and know this stuff. Well, and I've been working on energy issues for over 30 years now. And so, you know, I always end up thinking that I know the answer. What we discover is that, you know, there's not a single answer, there are many perspectives. And if you can combine knowledge with multiple perspectives, then you can come up with something that's hopefully going to be closer to that, you know, to that truth, or whatever you want to call it. My big learning is that every time you go into something like this, you go in with an open mind and an open heart. And if you do that, and you're listening to others perspectives, then you're bound to land on something that's a hell of a lot smarter. And then what you initially thought coming into it?   Dan Seguin  05:02 Okay, cool. Now, you were appointed chair for a recently formed Canada electricity Advisory Council. Can you tell our listeners who's on it? What is the mandate? And just how big of an undertaking is this?   Philippe Dunsky  05:19 Sure, I can start with the last question, by the way, that the undertaking, it's a really big issue, it's a really big challenge. On the other hand, the undertaking itself is time limited, it's a 12 month thing. So I'm a pumpkin and I turned into a pumpkin in May. It's been five months now. So I got another seven to go. From that perspective, that's the timing that we're looking at. Okay, Council itself is a group of 18 Canadians from across the country, every single, every single province, no exception. It's, it's extraordinary mix of individuals with an extraordinary mix of experience and perspective. So I'd say roughly half of council members are either current or former utility executives. The other half is a bit more of an eclectic mix of former regulators, we have people involved in the power production side of things, we have first nations leaders, so indigenous leaders, and a couple of others with different perspectives to bring to the table. But the really important thing here, I think, is that you're looking at the leadership level from every single province across the country. And that makes for really, really enlightening and challenging conversations as well. And then I guess you asked about the purpose or the mandate of the council. So I'll put it at a very, very fundamental level as a country, we're trying to largely decarbonize electricity by sometime in the middle of the 2030s. And we're looking to grow electricity, very substantially to decarbonize the rest of the economy. By 2050. That's that dual set of goals is at the heart of our mandate. And our mandate is to figure out what the feds can and must do. And at the same time, what can and must be done by others in the country, to help make this an easier journey, a more affordable journey. And ultimately, a more successful journey on the way there.   Dan Seguin  07:22 Okay, great segue here. Now, with respect to Canada's goal to achieve a 100%, Net Zero electricity system by 2035, you stated, "Is it better to optimize than maximize? Can you maybe break that down for us? And can you give us some examples?   Philippe Dunsky  07:41 Yeah, sure. I mean, you know, what I mean by that is, if all we do is say we want to decarbonize, there are many, many paths to do that. And, you know, we can say, hey, we're gonna, we're just gonna build, build, build, build, build until there's no tomorrow. And we could probably get there, doing nothing but that, but we'll get there in a less affordable way, than if we really think through the intricacies of what needs to be done. Yes, on adding, also on subtracting, so actually becoming more efficient in the way we use energy, relying more on consumers' involvement in the marketplace to achieve some of those goals. I just think there are quick ways to get to the goal, that ultimately, are going to cost too much and or create reliability issues. And if that happens, there'll be a backlash. And we'll never get to the goal. Alternatively, there, they're thoughtful ways that maybe aren't exactly the way we've always done things in the past, but that involve a lot more complexity and being able to wrestle with complexity and stuff. But ways that are focused on keeping this as affordable as possible, ultimately, for everyone across Canada, making sure that we do this in a way that's reliable, so we can always count on electricity being there. And in doing it in a way that actually involves some cooperation, as well.   Dan Seguin  09:04 So the electricity Council fulfills the minister's mandate to establish a pan Canadian grid Council. How viable is a pan Canadian electricity grid? Or are you seeing your movement in regional interconnections?   Philippe Dunsky  09:22 Yeah, so it definitely looks regional. Let me be really clear about that. And I know the original Originally, the name for the council was supposed to be the pan Canadian grid Council, as you pointed out, you'll also notice it, it was not it does not have that name. And there's a reason for that. And, and I will say, you know, and I've said this publicly many times, I don't believe that that's the right answer. We definitely need a lot more cooperation. at the regional level. There are a lot of opportunities for provinces to exchange more to continue exchanging with the US by the way, and this isn't, you know, we're not caught within, within our borders. So we have to do more on the cooperation side to keep costs down again, as low as possible to make this as smart and thoughtful and as achievable as possible. But that doesn't involve, you know, I love the old Coast to Coast Railway analogy. It's nice, it's working for railways. We're not talking about a single grid that goes coast to coast that's just not in the cards.   Dan Seguin  10:28 Now, for those who are not aware, can you tell us about your firm, its purpose, and what makes your approach unique, and particularly effective?   Philippe Dunsky  10:40 Sure, I mean, I'm thrilled talking about my firm. So these days, I spend so much time talking about look Council, which is kind of like my evenings and nighttime job, or evenings and weekend job. But my day job is running my firm, my firm is a group of over 50 professionals. Now, I think we're about 55 now that are dedicated exclusively to supporting clients in their clean energy transitions. And our clients typically are utilities and governments, increasingly large corporate clients as well, across Canada and across the US. So ultimately we work with utilities and governments that are in the throes of this energy transition, that are trying to figure it out. They're trying to find a way to help their customers navigate through it and a way for themselves to navigate through it, to define what the business case is for them and what their proper role is in it. And, and then we also have helped them in some of the nitty gritty. So, you know do you get customers involved on the demand side management side to reduce the pressure on right on the big build out? And all the capital is involved there? You know, what do we need to do to electrify vehicles, for example. So we've developed for some places, charging, charging infrastructure plans and charging infrastructure, business, business plans, strategies, investment plans, we work with, with our, with our customers in helping helping to decarbonize buildings through whether it's direct electrification, or hybrid heating systems without just the natural gas, depending on the on the need, we work with to decarbonize industrial loads, as well. And oftentimes, we're working with our utility customers to help them help their industrial customers decarbonize. So all of those things, and more and of course, planning out the whole transformation of the electricity system on the supply side, is a big part of it. That's a lot of what we do. It's hard to put in a single sentence. But the interesting thing, I guess, for us is, you know, ultimately, we're a consulting shop that is exclusively focused on the clean energy transition, we do nothing other than that. And, and I think that makes us pretty darn good at it.   Dan Seguin  13:02 That's perfect. Phillippe, your company emphasizes support in four focus areas, buildings, mobility, Industry and Energy. How were those identified? And can you maybe provide some specific projects or initiatives that have made a significant difference in the sector's?   Philippe Dunsky  13:25 Yeah, sure. And those sectors are, you know, 80 to 90%, of the energy equation, right. So they've grown over time, in a very deliberate manner, we started out working on the building side of the equation. So you know, what we call DSM or in Ontario, you call it CDM. Just to be different. But so we started out working on that. And then over time, we added mobility, especially electric mobility to our portfolio of expertise, and then built out from there, including on the generation and TND side, in terms of some examples. I mean, I'll be honest with you, we do well over 100 projects a year now. So there are a lot of different ones with a pretty large variety. But for example, I actually just came back from meeting with one of our clients, a large, large electric utility, where we've helped them to revamp their whole CDM approach. So that's, you know, from top to bottom, on the strategy side, on the regulatory side, and then on what the programs actually look like and how they operate and who they involve. In Ontario, we actually completed something I think is absolutely fascinating. I really enjoyed reading it. And that was a study of the potential of Drs. So distributed energy resources in Ontario to essentially keep the lights on, you know, we found 1000s of megawatts of exploitable resources there that you don't need to build because they're already there on the customer side of the meter. So stuff like that. We've worked with a lot of states in the US including California and New York designing, designing measure is to help their customers finance, the transition on their side, we've done a lot of work with, with utility executives helping them think through the strategy side of this, how am I going to actually the change management? How may I change my own utility to go from what it was in that steady state environment of the past 75 years to something that is a completely different beast in a very much more dynamic world. And it's focused on customer service and, and focused on transitioning the energy system as a whole. So, again, a pretty broad array of, of projects, but all of them. Absolutely. Absolutely exciting. And, and fascinating for me to be involved in and learn from.   Dan Seguin  15:45 Okay, now, wondering if you can speak to the importance of responsible and sustainable practices in the clean energy sector? And how has your company prioritized these principles in his work?   Philippe Dunsky  16:00 Yeah, sure. I mean, I mean, look, the world right now is looking to the energy sector to lead and to transform itself. And as we do that, you know, leaders have to have to walk the talk. So, you know, I'm, I'm very proud that most, if not all of my clients are doing that right now within their own operations. And my firm does that in our operations. I try to do that, in my own life, I've been driving nav for seven years. Now, it's a great way for me to, to, to lead by example, but also, quite frankly, to get a head and on the experience curve, and actually understand from personal experience, all right, what are the challenges of of EV ownership and what needs to happen to make it a more seamless process? So you know, that's on the personal side, my company, we're actually a B Corp. So we went through a process to be certified by an independent organization that looks at all of our practices, from soup to nuts. And in our score, our B Corp score has increased. Year over year, I think we started out somewhere about 80 Something points, and now we're at 119. So you know, it's just a process of continuous improvement, just like, just like all of our clients have to have to do.   Dan Seguin  17:12 Okay, cool. Now, we all know, there's always more every country can be doing to combat climate change. But it's complex. In your opinion, Philippe, how does Canada compare? Is it on the right track, and focusing its effort on the right initiatives?   Philippe Dunsky  17:34 Yeah, I think it's, I think Canada is, is definitely moving in the right direction. I think there have been a lot of very important policies brought forward over the past several years that I think, bring us forward. Are they all done exactly the way I would like them to be done? No, if I had a magic wand, would I do it a little bit differently? Probably, but directionally there. Actually, I think we're heading there. You know, that being said, it's a long and winding road. Right. And it will be for the next decade. So there will be setbacks, and there will be things that we're doing that are suboptimal. And that's a little bit part of life. So my job and the role I've kind of given myself and my firm is to help make that path as straight and narrow as it reasonably can be. But you know, recognizing that this is a big learning process and, and mistakes you're gonna make for sure.   Dan Seguin  18:31 Now, Philippe, what are some of the biggest challenges or even threats to achieving a clean energy future in the timeline set out by scientists and the government? How is your company positioned to address them?   Philippe Dunsky  18:46 The biggest challenges and threats and I'll decouple those questions, okay. Because I think that, from my perspective, there are enormous challenges. There's first and foremost, a challenge of time, right? Because what we're talking about if we're talking about, you know, getting to net zero or something like it by 2050. I mean, that's a single generation. So we're talking about literally transforming the backbone of modern economies in a single generation. That is, number one, because frankly, that's never been done before. We've done it within sectors, right, we've done we went from, from horse drawn carriages, to to you know, horseless horseless carriages. And you know, we've, we dumped manufacturer, gas and went, went to natural gas, and we've done individual changes like that before. We've never done all at the same time dealing with that and getting it done. The single generation is a race. And so I do think that time is probably the number one challenge number two challenge. And, you know, if you really take a take a step back here and think about what we're talking about it, it's largely from an economic standpoint, we're largely moving from optics to capex, and there's we're largely it moving from a context where whether it's utilities, or business owners or homeowners, today, we pay our bills, you know, we're buying fossil fuels, right, we're buying and burning the energy that we consume. And so that's an OP X thing. Now, what we're talking about is increasingly stuff, that's just all capital, if you think of, you know, going from a gas plant to, let's say, a wind farm, a wind farm is, you know, it's once and done all of the entire cost for next 20 years, or 95% of it goes in the ground on day one, that's moving objects to capex, it's a really big change. If you're thinking of it from a homeowner perspective, we're talking about, let's say, take my example, you know, I bought an Eevee, my Eevee cost a lot more than that my previous gas car did. On the other hand, I'm paying a hell of a lot less to keep it up to optics to capex. So there's a real challenge around getting enough capital for all this to happen, whether it's for large utilities or down to an individual homeowner or car owner, I think that's a real big challenge that we have a couple more, maybe I'll, maybe I'll stop there. And then the things that my firm is doing to address those, I mean, look, like I said before, on the timeline side, everything we're trying to do is just minimize errors, we're not gonna eliminate them, but minimize errors. So that that line between here and there can be as straight as possible, and as least painful as possible on the capital side, that's a very specific thing. But we actually do a lot of work developing innovative financing mechanisms that utilities and governments can offer to homeowners and business owners, to allow them to have access to the capital that they need, as they tried to save money on the operation side. So those are, those are a couple of them, anyhow.   Dan Seguin  21:57 Okay, Philippe, what do you want Canadians to know about the country's transition to clean energy that they might not already know or be aware of?   Philippe Dunsky  22:10 You know, I think, I think everyone is aware that this energy transition is really big, and it's gonna be really hard. Maybe the one thing I'll add on to it is, there's a lot of benefit on the other side of this. So a lot of benefit, you know, what we're talking about ultimately, is, is transformative in nature, it's the sort of thing that's happened. I'm thinking outside of the energy sector, but just holistically, these kinds of changes have happened a few times in the past 100 years or so. And they tend to always be ultimately about moral leadership to start. And so I think we need to think of this, first and foremost from the perspective of moral leadership, which is something that is one of the reasons why Canada has such a great, strong brand around the world, because we punch above our weight on the great moral issues of the times. And that was true when we went to help out Europe during World War Two, and that was that true. And we went Mulrooney led the boycott of South Africa under apartheid. I mean, we've stood up when we've needed to, that has positioned this country internationally in a way that I don't I'm not sure that we fully measure. This is one of those times. And so being at the forefront of this, I think is extraordinarily important for our country as a whole. That being said, there's also some really economic benefits at the end of this and flip it on its head to there's some real economic costs and risks if we don't do this, and if we don't get it right, well, one thing, one thing I'll point to, I remember about 10 years ago, being in conversations with some provincial governments about the possibility of governments eventually taxing imports of our products, if they're too carbon intensive, and the idea sounded a bit crazy back then we're recording this today on October 30 29 days ago, on October 1, Europe's carbon border adjustment mechanism came into effect for the first time. And that is effectively going to tax import of products from everywhere around the world based on their carbon content. So if we get ahead of this fast, if we succeed in this, if we lower our carbon content of what we produce, we've got a hell of a nice economic advantage at the end of it.   Dan Seguin  24:33 Now, what advice would you give to an aspiring entrepreneur or those looking to make a positive impact in the clean energy and climate sectors?   Philippe Dunsky  24:48 You know, my advice is it's gonna sound a little wishy washy, but it's just figuring out what you're great at. You know, everyone's great at something different so I have a hard time. I'm providing really concrete advice to people I don't know personally, but everyone's got their magic. Everyone's got their special exceptionalism. I think it's important to know who you are, know what you really like to do know where you excel, and then whatever that is, to the extent that you can bring that to service of a greater cause, whether it's climate, whether it's portability, whatever it is, I think that's just a beautiful thing. So I encourage everyone to ultimately lead a purpose driven life and, and lean on their own strengths wherever they may be.   Dan Seguin  25:35 Okay, that's fair. Lastly, Philippe, we always end our interviews with some rapid fire questions. Are you ready? Maybe. Okay, here we go. What are you reading right now?   Philippe Dunsky  25:51 Right now I'm actually sounding nerdy but I'm actually reading the CIA's 2030. Outlook, the latest 2030 outlook by the International Energy Agency. Absolutely fascinating read. If you're a nerd, like I am about energy.   Dan Seguin  26:04 Now, what would you name your boat? If you had one? Or maybe you do have one?   Philippe Dunsky  26:10 My boat? My boat is a canoe. And what would I name my canoe? I'm not sure. Maybe I named it the Power Canoe. One of the reasons I love canoes, by the way, is they're probably the most efficient way of getting from point A to point B on water. So I'm a big fan of energy efficiency and, and a canoe is just that.   Dan Seguin  26:31 Who is someone that you truly admire Philippe?   Philippe Dunsky  26:35 Oh, goodness, I admire so many people, I couldn't come up with a single name there. You know, I work with a lot of leaders who dedicate their time and energy and excellence to, for public purposes. And every single one of those I'm in deep admiration of, I'll maybe add one other group, the folks I work with here in my firm. I've never known a group of people as dedicated and passionate and smart and curious. As they are, they do inspire me.   Dan Seguin  27:05 Good, good. Okay. What is the closest thing to real magic that you've witnessed?   Philippe Dunsky  27:10 I'm from Quebec. So I'm a big fan of the circus, the modern circus, whether it's Cirque du Soleil, Cirque Éloize or les Sédois de la mayenne, they always amaze me and I'll always leave me spellbound.   Dan Seguin  27:24 Okay, next, as a result of the pandemic. Many of us are guilty of watching a lot of Netflix or other streaming platforms. What's your favorite movie or show?   Philippe Dunsky  27:38 You know what, I watched many different Netflix shows. These days. I'm just trying to think what's in bridgerton would be one of them right now. I'm really enjoying it.   Dan Seguin  27:52 Now, lastly, Philippe, what's exciting you about your industry right now?   Philippe Dunsky  27:58 What's exciting is the same thing that's exhausting me. And that's the pace of change. It's just an extraordinary time right now. And I'll tell you what's really exciting me is that five years ago, because this is all I do. Right? I'm a one trick pony. So I think about this every day. Five years ago, I felt pretty alone in seeing and understanding the pace of change that we needed today. I feel like pretty much every leader I speak with is very clear eyed about how big this is, how fast it's gotta go, the challenge that it represents, and the near the you know, the knowledge that we need to get going and get going in a big way. So that excites me.   Dan Seguin  28:37 Now, if our listeners want to learn more about you, or your organization, how can they connect?   Philippe Dunsky  28:44 Well, my organization's website is very simple. Dunsky.com. That's probably the easiest, easiest way. And if you want to connect with me, try info@dunsky.com or my own email. The simplest email in the world is philippe@dunsky.com.   Dan Seguin  29:05 Well, Philippe, this is it. We've reached the end of another episode of the thinkenergy podcast. Thank you so much for joining us today. I hope you had a lot of fun.   Philippe Dunsky  29:15 It was fun. Thank you. I love your questions.   Dan Seguin  29:18 Thanks for tuning in for another episode of the think energy podcast. Don't forget to subscribe and leave us a review wherever you're listening. And to find out more about today's guests from previous episodes, visit thinkenergypodcast.com. I hope you will join us again next time as we spark even more conversations about the energy of tomorrow.  

Shows Main Idea – Rick interviewed Dr. Daniel R. Berger II, the founder and director of Alethia International Ministries (AIM), where he continues to write and speak around the world in churches, organizations, medical communities, and at various counseling and teacher's conferences. He is also an experienced pastor, counselor, school administrator, and the author of many books, which focus on biblical counseling, biblical phenomenology, practical theology, education, parenting, and the history and philosophy behind the current mental health construct. In this interview, Rick asked Daniel several questions that were submitted to Rick after he led a conference in Calgary, Canada. Instead of Rick answering them, he asked Daniel to share his perspective on the Bible, disorders, DSM-5-TR, medications, and more. This interview was divided into two parts. Here is part two. Show Notes: https://lifeovercoffee.com/podcast/ep-487-daniel-berger-discusses-disorders-and-medication-pt-2/ Will you help us to continue providing free content for everyone? You can become a supporting member here https://lifeovercoffee.com/join/, or you can make a one-time or recurring donation here https://lifeovercoffee.com/donate/.

* Mets-toi en présence de Dieu, pour essayer de Lui parler. * Tu disposes de 10 minutes, pas plus : va jusqu'au bout, même si tu te distrais. * Persévère. Prends ton temps et laisse l'Esprit Saint agir 'à petit feu'. Un passage de l'Évangile, une idée, une anecdote, un prêtre qui s'adresse à toi et au Seigneur, et t'invite à entrer dans l'intimité de Dieu. Choisis le meilleur moment, imagine que tu es avec Lui, et appuie sur play pour commencer. Toutes les infos sur notre site : www.10minutesavecjesus.org Contact : 10minavecjesus@gmail.com DSM

It all started when a 4th grader at my daughter's school asked me if I'm neurodivergent after I finished doing a read aloud of my book to their school. And I don't know why but I stumbled over my words. I kept thinking about it over and over again that day and then shared it to my stories with a question, am I neurodivergent? Sensory Detectives Waitlist (next cohort: early 2024) Episode transcript: https://www.theotbutterfly.com/podcast The OT Butterfly Instagram: https://www.instagram.com/theotbutterfly Work with Laura: https://www.theotbutterfly.com/parentconsult Buy "A kids book about neurodiversity" : www.theotbutterfly.com/book

SPOILER ALERT: WATCH ENTIRE SERIES FIRST This is an introduction episode to a larger project that examines the toxic family system of The Logan Family on the HBO series, Succession. This episode explains the premise for the analysis and the themes which will be explored and highlighted throughout the series. Each episode will focus on one character per season in order to fully examine the character development throughout each season. Below is the Table of Contents. IT'S LONG, I know. This is going to be in-depth so saddle up and get ready to dig deep into this toxic, cult-like family system. 0:00 Intro 15:32 SNAP Spectrum of Abusive Personalities 20:04 What is Narcissistic Abuse? 29:00 Three Important Questions 34:50 Transactional Relationships 37:30 Flying Monkeys 40:56 Future Faking 45:39 Gaslighting 48:27 Controlling the Narrative 53:55 Love Bombing 1:02:17 Discarding & Devaluing 1:06:18 Projection 1:10:59 Coercive Control 1:16:25 Objectification 1:19:41 Callousness & Cruelty 1:25:10 Narcissistic Amnesia 1:28:32 Weaponizing Information 1:31:00 Targeting the Vulnerable 1:32:49 Wildlife Metaphors ⁠⁠Website: www.clermontmentalhealth.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email: snap@clermontmentalhealth.care Text: 513-655-6101 ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube Channel⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram: @theofficialsnap FB Page: @mfriedmanlpcc ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SNAP FB Group⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter: @mfriedmanlpcc Mandy Friedman, LPCC-S, CCDVC, CCTP-II, CCMHC is a Licensed Professional Clinical Counselor, a Certified Clinical Domestic Violence Counselor, a Clinically Certified Trauma Professional and a Certified Clinical Mental Health Counselor. Mandy is the creator of the educational recovery program SNAP: Survivors of Narcissistic & Abusive Personalities. This program teaches survivors and concerned loved ones about abusive personalities, targets of abuse, abusive relationships and life in recovery from abuse. SNAP educational program of recovery helps empathic survivors of abuse fine tune and connect with their empathic nature in order to preserve, harness and protect the very things abusers seek to destroy. In her private practice, Clermont Mental Health, Mandy specializes in treating survivors of Cluster B personalities. She is also familiar with the role of addiction, substance abuse and self-harm in abusive relationships. Mandy's clients are often in need of trauma-informed care as part of their recovery. This has led her to specialize treating clients with Complex Post Traumatic Stress Disorder (C-PTSD). To help her clients, Mandy utilizes mindfulness based cognitive therapy (MBCT), cognitive behavioral therapy (CBT), psychoeducation and Polyvagal Theory. Mandy is a survivor of abuse and has first-hand knowledge of what survivors endure in abusive circumstances and living a healthy life after abuse. Disclaimer: This content is intended for educational purposes only. It is not a substitute for mental health treatment. It is important for survivors of abuse to find mental health professionals who understand trauma and abusive relationships. Please seek support from trusted and trained practitioners. This content is not meant to be used by anyone as diagnostic criteria. Permissions have not been granted for anyone to utilize this material as a source to make allegations about specific individuals. Any online content produced by SNAP: Survivors of Narcissistic & Abusive Personalities, Clermont Mental Health or Mandy Friedman LPCC-S is an educational discussion about narcissism which is a descriptive term for tendencies and behavioral patterns. Individuals with narcissistic features or tendencies do not necessarily meet DSM diagnostic criteria. The terms narcissistic and narcissism are used as descriptions of tendencies and behaviors and are not meant as clinical terms. --- Support this podcast: https://podcasters.spotify.com/pod/show/mandy-friedman-lpcc/support

In this episode we discuss the early crimes and prison life of Bonin, who killed 21 young men in California in 1979-80. TRIGGER WARNING: Sexual assault of minorsE-mail me at Pugmomof1@gmail.com; visit me on Instagram as True Crime University_Donate via PayPal to help me keep the show going: bullymom7@yahoo.com  True Crime University is part of the Debauchery Media Network. Visit all our podcasts at welcometothedebauchery.com References:   Wikipedia, Without Redemption by Vonda Pelto, PhD, and Michael Butler, allthatsinteresting.com, dsh.ca.gov, ojp.gov, mayoclinic.com, "I Survived a Serial Killer", Season 1, Episode 10, crimelibrary.org, "Evaluation of Personality Disorder Diagnosis in the DSM"- 1998Support the show

Shows Main Idea – Rick interviewed Dr. Daniel R. Berger II, the founder and director of Alethia International Ministries (AIM), where he continues to write and speak around the world in churches, organizations, medical communities, and at various counseling and teacher's conferences. He is also an experienced pastor, counselor, school administrator, and the author of many books, which focus on biblical counseling, biblical phenomenology, practical theology, education, parenting, and the history and philosophy behind the current mental health construct. In this interview, Rick asked Daniel several questions that were submitted to Rick after he led a conference in Calgary, Canada. Instead of Rick answering them, he asked Daniel to share his perspective on the Bible, disorders, DSM-5-TR, medications, and more. This interview was divided into two parts. Here is part one. Show Notes: https://lifeovercoffee.com/podcast/ep-486-daniel-berger-discusses-disorders-and-medication-pt-1/ Will you help us to continue providing free content for everyone? You can become a supporting member here https://lifeovercoffee.com/join/, or you can make a one-time or recurring donation here https://lifeovercoffee.com/donate/.

Release date: October 27th, 2023 Dr. Laura Roberts is joined by Dr. Carolyn Rodriguez and Dr. Randy Frost, authors of the new book Hoarding Disorder – A Comprehensive Clinical Guide, which tackles a condition which has been part of the zeitgeist for a while now (just ask fans of Marie Kondo) yet was only codified as a disorder in the DSM-5 in 2013. This is therefore a pioneering new work in the field, and the authors discuss the book's genesis and their ambitions for understanding and treating a condition now thought to be more prevalent than OCD. In this episode: Introduction (0:30) Why did the world need this book? (2:27) The Collyer Brothers (4:45) The natural history of the condition in younger patients (7:00) The status of research in the area (10:25) the tipping point (14:24) Who's psychologically uncomfortable here? (22:10) How do we do a better job of recognizing this disorder earlier? (28:10) Hoarding, affluence and popular culture (37:03) Understanding the nature of the attachments that people have (38:50) Show Notes and Resources:Hoarding Disorder – A Comprehensive Clinical Guide by Dr. Carolyn Rodriguez and Dr. Randy Frost (American Psychiatric Association Publishing) 2023 Learn more about Dr Rodriguez and Dr Frost. Read more about the Collyer Brothers. Transcript and More Episodes: https://psychiatryonline.org/psychiatry-unbound

Thanks to Gabor Maté, we know that trauma isn't just something that happens; it's something that happens inside of you. So when something happens to us (or doesn't happen, like in an omission of care) and we feel anxiety, that anxiety is a result of trauma. Anxiety can come from so many things, like overextending ourselves and trying to do too much, divorce, job loss, and even things that some might perceive as positive experiences like an upcoming social event, wedding, or vacation. And often we feel this way not because we are anxious people, but because our relationship with anxiety has been wired a certain way. And we know that neuroplasticity allows us to rewire our relationship with emotions, sense of self and identity. How cool is that? When we can expand the definition of anxiety outside of what the DSM and the American Psychological Association tell us it is, we can start to see the value of EMDR treatment for people who experience anxiety. This is a beautiful thing. This week on the Zero Disturbance podcast, I'm talking about what anxiety and trauma actually are, and why professional associations in the psychological space need to expand their official definitions so that more people can easily access the support and treatment they need. And I'm sharing why EMDR is a great choice for people who have experienced anxiety or who have been told they “have anxiety.” This is especially important so we can create more hope for people so they don't think they have to “have anxiety” forever, as part of who they are. When something traumatic happens to us, it can be healing to have a therapist listen to and/or validate our horrible experience, especially if no one else has before. However, rehashing the details of that traumatic event can be retraumatizing. Brain-based therapies like EMDR teach us that we don't have to talk about the trauma or the details if we don't want to because the real healing doesn't focus on the traumatic event itself. The Zero Disturbance podcast is for educational purposes and is not a replacement for a therapeutic relationship or individualized mental health or medical care. Come learn with us at Zero Disturbance: Want to learn more about empowering yourself to experience therapy on your terms? Get access to our free client resource library for the most up-to-date tools and resources for your own journey. Therapists, access our favorite free resources in The Zero Disturbance Welcome Bundle, full of free videos and downloads to help you develop your clinical reasoning skills, as well as ways to feel like an intentional designer of high-value offerings like intensives and passive income. Use these free resources to make the seemingly impossible feel absolutely accessible! With a Masters in Education from Vanderbilt, Kambria has been creating trainings and teaching adult learners for over 20 years. As the Director of Education and Quality Improvement at Stanford Medical School, she created ease in complex systems, thereby giving medical trainees successful learning experiences. Now, as a dedicated mom, therapist, and EMDR Consultant, Kambria knows what it means to do things efficiently, effectively, and in a learner-centered way. When she isn't podcasting or creating online courses, you can find Kambria playing with her twins on a beach in California. Need help with bilateral stimulation? I use TouchPoint for myself, my kids, and in my practice. They're both affordable and discreet! Shop here and use the coupon code ZERODISTURBANCE for 12% off. Disclosure: Some of the links provided are affiliate links. If you choose to make a purchase through these links, I may receive a small commission at no extra cost to you. This helps support my work. Thank you for your understanding and support!

Ever wonder what the differences are between the ways non-Autistic ADHDers and Autistic ADHDers process and move through the world? In this episode, Patrick Casale and Dr. Megan Anna Neff, two AuDHD mental health professionals, talk with Dr. Donna Henderson, a non-Autistic, ADHDer psychologist, about her personal experience as an ADHDer, as well as explore the overlap and differences between ADHD and autism. Top 3 reasons to listen to the entire episode: Understand what life looks like as an ADHDer in regards to things like executive functioning, sensitivity and reactiveness, conversational tempo, working memory, and task switching. Identify the ways Autism and ADHD can influence how we process information and engage in conversations, as well as how this shows up in relationships. Learn about what it really means to do self-care and how to break free from the generic standards of healthy living to act in alignment with what you actually need and want. There is a surprising number of differences between the way Autistic individuals and ADHDers might experience the world. This episode only covers the experience of one ADHDer, so we encourage you to further explore the nuances and diverse perspectives of ADHDers. More about Dr. Donna Henderson: Dr. Donna Henderson has been a clinical psychologist for over 30 years. She is passionate about identifying and supporting autistic individuals, particularly those who camouflage, and she is co-author (with Drs. Sarah Wayland and Jamell White) of two books: Is This Autism? A guide for clinicians and everyone else and Is This Autism? A companion guide for diagnosing. Dr. Henderson's professional home is The Stixrud Group in Silver Spring, Maryland, where she provides neuropsychological evaluations and consultations for children, adolescents, and adults who would like to understand themselves better. She is a sought-after lecturer on the less obvious presentations of autism, autistic girls and women, PDA, and on parenting children with complex profiles. She also provides case consultations and neurodiversity-affirmative training for other healthcare professionals. Dr. Donna Henderson's Website: drdonnahenderson.com  You can grab Dr. Donna Henderson's books here: isthisautism.com Dr. Donna Henderson's Masterclass on PDA (with Neurodivergent Insights): https://learn.neurodivergentinsights.com/pda-masterclass/ (As a listener use “PDA10” to get $10.00 off the Masterclass!   Transcript PATRICK CASALE: So, Megan and I are very excited to introduce our little miniseries within a series about interviewing different neurotypes within the neurodivergent and neurodiversity communities. We want to just put a big, big, big, big disclaimer out there that we understand that by interviewing one person per neurotype there are lots of different perspectives, different experiences, one person does not speak for the entirety of a neurotype. And we just want to really make that clear. But we are really excited today for our guest and our interview with our Ask an ADHDer. And I'm going to turn it over to Megan. MEGAN NEFF: Yeah, so likewise, I'm really excited for this series. And I think it's kind of a playful series. And I'm glad you mentioned the disclaimer of, of course, we're not going to nail down all experiences in one interview per neurotype or however many we have. But I cannot think of a better person to be, kind of, getting us started on this process than Dr. Donna Henderson. I am just going to gush over to you for a minute, Dr. Henderson. I hope that's okay with you. I don't like when people gush over me. I hope you have more tolerance for it. DONNA HENDERSON: I have mixed feelings about it. MEGAN NEFF: Okay, we could process that, we have to. I am such a fan of your work, as you know. Dr. Donna Henderson has done a lot in, I would say, advancing the conversation around non-stereotypical autism. She and her co-authors just released two books this summer, Is This Autism? Which is a green book. And then the second one, Clinicians Guide. What's the other book? DONNA HENDERSON: So, they're both called Is This Autism? And the subtitle is different. MEGAN NEFF: The subtitle is different. DONNA HENDERSON: The subtitle of the first one is A Guide for Clinicians and Everyone Else. And the second one is A Companion Guide for Diagnosing. MEGAN NEFF: Got it. So, if you're a clinician, check out the blue book. And if you're everyone else, check out the green book. Am I oversimplifying? I'm sure I am. DONNA HENDERSON: A little bit because we feel really strong… we wrote them as one book and we were very upset when they had to be divided into two books. But you know, I went way over my word limit. And- MEGAN NEFF: Understandably, it's a complex topic. DONNA HENDERSON: It is. And we really want clinicians to start with the first book because the first book tells you kind of know what to look for. And the second book tells you how to look for it. And if you don't know what to look for, it doesn't matter if you know how to use- MEGAN NEFF: I love that- DONNA HENDERSON: [CROSSTALK 00:02:35], yeah. MEGAN NEFF: Okay, I'm actually so glad, like, that was just a divergent trail based on the introduction. But I'm actually really glad we had that conversation because I've been wondering how to recommend your books. And I've read the green one, not the blue one yet. And I remember thinking like, this is so much helpful information for a clinician in training. I want alternative programs to have your book. So, yes, one of the reasons I love your book and I love you is because I think you're putting… So, Routledge just published it. This is a really academic, solid publisher. I think it's really hard for a medical provider to look at the case you put forward and say this is rubbish. And so that is one of the reasons I'm such a fan of your book is you're taking what is, I would say, known in the autistic community, and really putting kind of a research backbone to it, to where it's going to be hard for the field to continue to depend on stereotypical ideas around autism. DONNA HENDERSON: Yeah, and that came from, it's the way I structure my reports. I literally use the DSM diagnostic criteria. And people have all kinds of feelings about them but I think if you actually understand the scope of them, and what they really mean, then they do make sense. And they can be very clinically useful. And so when I write a report for somebody who is autistic and has been misunderstood over and over and over again by their health care professionals and everyone else, I literally write how they meet each diagnostic criteria because I want to arm them with that document, so a future healthcare professional can't say, "Well, I don't think you're autistic." Because they have the proof, you know? MEGAN NEFF: Yeah, yeah, well, and now you've done that for a wide audience, which is why this is so valuable. Okay, I'm bringing myself back on track. So, other than these fantastic books, like, also, I've been at your trainings, I've heard your trainings, I've posted some of your trainings around PDA, around autism in girls. I know there's a podcast that has, like, gone viral where you walk through the DSM criteria for girls. So, you're well-known in this field as an expert on autism. So, you being on our podcast today is a little bit different because we asked you to come on to speak from your personal experience as an ADHDer. I think it's so interesting, here you are at the forefront, I would say, of the clinical research around autism and you're an ADHDer, which you talk less about. I have heard you talk about it here and there, but I haven't heard you talk about it in depth. So, first, I'm just curious, what is it like to be coming onto a podcast where it's not like ask the expert, it's let's talk to Donna the ADHDer? DONNA HENDERSON: It's a little bit nerve-racking, you know? To do, you know, something more personal, but I ask people to tell me their personal stuff all day, every day. So, turnabout is fair play, I guess. And I think one of the reasons I'm drawn to, you know, studying, and working with, and writing about, and talking about autistic people because what resonates with me is I was misunderstood for so many years. You know, I'm 58 years old. And so I had no hope of being diagnosed as an ADHDer when I was a kid. I was also you know, a girl who, you know, found school to be relatively easy. I messed up a lot, I didn't get the best grades, and all that, but it wasn't super effortful for me. And so I had no hope of being identified. I got identified and diagnosed when I was in my, I think, mid to late 30s. And so I understand, to some extent, at least, what it's like to be misunderstood, and then to internalize all the shame and blame, and to, you know, blame yourself, and be really hard on yourself. And then to have that experience of somebody seeing you and saying, "Actually, this is what's been going on." And how unbelievably life-changing that can be. MEGAN NEFF: Yeah. It's so liberating, so liberating. And this is something I think Patrick and I have talked about some, but I'd be curious what some of your internalized labels were? I think different and both shame-based, but I think some of my most, like, just aggressively negative labels I've put on myself is actually more from my ADHD than my autism. Do you feel comfortable sharing what were some of the internalized narratives that came online for you, having been undiagnosed till your thirties? DONNA HENDERSON: Sure. Definitely, when I was younger, like in high school and college, lazy. I knew I was smart, I knew I was capable of, you know, advancing in my academic career, and yet, you know, I avoided hard work, I couldn't sustain attention or effort sometimes. And so, definitely, I thought of myself as lazy. And now I realize I'm absolutely anything but lazy. MEGAN NEFF: Right, when you literally just came out with two books this summer. DONNA HENDERSON: Yeah, so that's been a big change. But that was, you know, the first half of my life, I definitely thought of myself as lazy. One that I'm still really struggling with is sensitive. I grew up with people constantly saying, "You're so sensitive, you're so sensitive." In a negative way. And I definitely internalized that as something incredibly negative. And now, I definitely still struggle with it and there are many times I wish I was less sensitive, and I get mad at myself for having such big emotional reactions. But at least I understand it's not a character or logical problem, this is my wiring. And that gives me a fighting chance of not, you know, blaming myself at the end of the day. MEGAN NEFF: I love how you word that, not a character or logical, it's my wiring. Okay, so this is going to kind of trail us somewhere. And I'm curious what you mean by sensitivity? Because I know like emotional regulation is harder when we're ADHDers. But also, I'm thinking about like, HSP, highly sensitive person kind of phenotype. Something I see a lot in the autistic community right now are folks saying and I used to say this too, focusing HSP is just a repackaging of autistic traits. I've backed off that because I've now seen and, like one of my kids is an ADHDer who also wouldn't be considered HSP. I'm curious, like, does the HSP, that highly sensitive person, is that part of what you meant by sensitive? Does that fit your experience? DONNA HENDERSON: I read that book so long ago, it's hard to for me to remember. MEGAN NEFF: Yeah, it's- DONNA HENDERSON: I could say, I'll sort of make a differentiation, I think. My sensitivity, I would say, most of it, is about me feeling judged or criticized easily. MEGAN NEFF: Okay. So, like rejection sensitivity, emotion regulation sensitivity. DONNA HENDERSON: Yes, exactly- MEGAN NEFF: Okay, cool. No, that's what I was- DONNA HENDERSON: It's very specific to that as opposed to a more general, like I just finished a parent interview this morning about their daughter who, you know, I don't know yet, but I suspect she's autistic. And my gosh, this poor girl is hypersensitive to everything, just everything, throwing out a used crayon, she feels really badly for the crayon, but like, you know, it's so generalized her sensitivity, and you know, sensory stuff, and all of that. I don't experience that level of very generalized sensitivity. For me, it's that specific sort of RSD kind of thing. MEGAN NEFF: I love how you can put words around this stuff. Okay, so sensory, that's a big overlap, but I like how, again, you are… and I feel like another conversations I've had with you it's the globalness of some of the things that distinguish like autism from ADHD. But, yeah, what is your kind of sensory experience of the world? DONNA HENDERSON: Yeah, so I think my perspective is that ADHDers and autistic people, one area of overlap with sensory stuff is hyperresponsivity to, you know, all kinds of things. You know, noises, lights, whatever. And I have a little bit of that. It's just a little though it doesn't majorly affect my life. I put on clothes that feel comfortable to me, that may or may not look great. But comfort is the most important thing. If I have to wear something uncomfortable, though, it's not the hugest deal in the world. So, I would call it a minor hypersensitivity. So, as opposed to one of… well, I won't get into that story, never mind. I think that sort of hyperresponsivity is pretty typical in a lot of ADHDers. What I don't see a lot in ADHDers, but I see more in autistic people is hyporesponsivity, being less responsive to internal or external sensations. And I don't see a lot of atypical sensory craving. Sometimes sensation seeking if you have hyperactivity impulsivity, but not atypical sensory craving, like looking objects or smelling objects. That's just not typical. MEGAN NEFF: I love that. Okay. And this is more question for clinical Dr. Henderson. I've often thought hypo responsivity and sensory seeking kind of went together. Like, if someone was hypo, then they might be sensory seeking because they're looking for that additional input. But am I kind of conflating ideas there? DONNA HENDERSON: I mean, I think they can go together, but I think of them as separate things, you know? And when I think of hyporesponsivity, I think of interoception more than any other sensory system really, and like not perceiving, or contextualizing, or understanding, or responding to your internal sensations as much. MEGAN NEFF: So, like, with interoception would you have pretty accurate understanding of what's happening inside your body? DONNA HENDERSON: Me? MEGAN NEFF: Mm-hmm (affirmative.) DONNA HENDERSON: I think so. I mean, when I've learned about it, it never resonated with me, I'm like, "Oh, my God, that explains it." Now my son, who is autistic, he's 22 years old. He has really, really, really low interoceptive awareness. And it's so important, I think, for clinicians and for everybody to understand this because I think people call it denial if they don't understand the physiological basis. MEGAN NEFF: Absolutely, yeah. DONNA HENDERSON: And I remember once he was in therapy with someone for he has a really bad needle phobia. And this became a crisis when he needed the COVID vaccine, of course, and so he was in in therapy for that. And she was doing a hierarchy, and she had him watch a video of somebody getting a shot. And he literally, like, scooted his chair back, he gasped, he put his hand to his mouth, and she stopped the video and said, "So, you're feeling anxious?" And he said, "No, I'm not." And I think that therapist could mistakenly call that denial, which is a psychological defense mechanism. But no, he genuinely did not realize he was anxious and that's really global for him. MEGAN NEFF: Yeah, yeah, yeah. I have so many thoughts, but Patrick, I've been hogging the conversation, so… PATRICK CASALE: You can continue to hog it. I'm lost in my own head. So, I'm just paying attention and listening. MEGAN NEFF: Patrick flew yesterday, he traveled yesterday. PATRICK CASALE: Yeah, I had at 5:00 AM flight out of California- DONNA HENDERSON: Oh, my God. PATRICK CASALE: Got back to East Coast at 7:30 PM. So, my brain is not online. DONNA HENDERSON: I feel you and I love it [CROSSTALK 00:14:58]. No, I was just going to say that. And you know what, that's something that has evolved for me as an ADHDer. I used to try to hide it a lot more. And now I'll say things like that, you know whether or not I have a good excuse like you do. I'm more willing to say in conversations, you know what? I just completely blanked out for no good reason. I actually really want to hear what you just said. Can you tell me again? And it's sort of freeing to be able to do that and not to constantly feel like I have to pretend I'm paying attention perfectly well all the time. PATRICK CASALE: Megan and I just released our episode on masking. And that is just kind of the definition for me, in regards to communicating how I'm experiencing conversation or social interaction, is just to be like, I'm not really able to follow this or pay attention to this right now. I'm sorry. Like, I'm here, but I'm not here. DONNA HENDERSON: Right. MEGAN NEFF: Yeah, yeah, yeah. I think that's a beautiful example of ADHD and masking to be able to own like, I'm sorry, my brain's space off, I do care about you. One, I've been getting more and more requests for resources for ADHD couples. You know, Kate McNulty has a great book for autistic partners. But I am yet to find like a really good book for ADHD partnerships. And I think this sort of thing happens a lot where the ADHD partner, we get distracted or we misplace something significant like keys, and the other partner experiences it as us not caring. DONNA HENDERSON: Yes. MEGAN NEFF: And yes, so I love how you model that ability to be able to say, whether it's to your spouse, or to someone else, like actually, I do care about you, my brain just, you know, went offline for a minute, DONNA HENDERSON: Right, but it's hard because, you know, it takes a lot of self-awareness on everybody's part. And then it takes communication on everybody's part. So, here's an example. I listen late. So, when somebody starts talking to me, it takes me a few seconds to realize, "Oh, this person's talking to me, and I missed the first sentence." Right? And so my husband will walk into my, you know, I'm in my home office now. He'll frequently just walk in and start talking while I'm writing. And then by the time I realize he's talking, I've missed, you know, the important first sentence or two, and then he gets upset. Like, "Hey, how come you don't listen to me?" And so I've had to explain, here's what I need, I need you to walk to me, say my name, and wait for me to look up, and then problem solved, right? MEGAN NEFF: I love that because I feel like that's like advice you give ADHD parents. Like, get their name, get some sort of, like, visual cue. That's been so helpful in my family since discovering, you know, the majority of us are neurodivergent is task-switching language. Like, so if a child now comes up to me because that used to happen a lot with children, I'd be hyper-focused. And I'll now say like, I need three minutes to task switch out of this, and then I'll be able to help you. And to be able to just have that language of like, "Give me a minute to task switch then I can actually take in your words." But yeah, I think that was actually one of our questions we wanted to ask you was around like, task switching, hyper-focus. Sounds like you're- DONNA HENDERSON: Oh, God, switching, it's like my nemesis. I mean, sometimes I switch too easily, right? I'm writing a report, I'm into it, and I'll randomly think, "I should check my email." And then I do. And I realized that that's not, I'm trying not to judge myself too much for that because, as Johann Hari says, in his amazing book on attention, you know, there are 10,000 engineers on the other side of your screen that are doing that to you, right? There are forces that have nothing to do with my ADHD that are pulling my attention in this culture that we're now living in. But yeah, sometimes I switch too easily. And then other times, I can't switch when I want to switch. So, I wish I just had more control over my switching and as a hyperactive type ADHDer, I need a lot of stimulation. So, I tend to jump from one task to another, which is not good, you know? It makes you make mistakes, and makes up less efficient, and is sort of tiring. So, what's a girl to do when she needs a lot of stimulation, and which switch, right? MEGAN NEFF: I call it my tree branch projects where I will like, I'll switch to something because it might be like, I'll check my email, but then, like, will turn into this huge project and like, I'll be five steps over on a project. And like, how did I get on this? Like, why am I making a new landing page with a new… Like, why? Oh, because I checked my email, and that led to this which led to this, which I think I've found ways to structure my life where I have space for tree branch projects, which I've noticed that reduces my executive, like, stress a lot just by having the bandwidth to be able to chase those. But it is really stressful. And it's like, I just want to get this thing done, but I'm five steps over here. DONNA HENDERSON: Yeah, but what I'm hearing is that you sort of changed the narrative about it. And so it's not necessarily a bad thing when you go off and do a new project. It's a branch of the tree, you know? And every branch has its own place, right? So, just thinking about it differently could be helpful. MEGAN NEFF: Yeah, yeah. And I think- PATRICK CASALE: And because I think you can- MEGAN NEFF: Yeah, oh go ahead. PATRICK CASALE: Sorry. I think you can get into the narrative, you know, especially, for a lot of ADHDers of like those "tree branch projects" that Megan's referencing as like, "I can't finish anything, I can't follow through with anything. Every time I start something, I diverge somewhere else and that makes me really frustrated with myself." So, just the ability to reframe that and think about it differently. I think, like you're saying, Donna, is super helpful. DONNA HENDERSON: Yeah, I'm really great at starting things. MEGAN NEFF: This is where I think my autism really helps my ADHD is I typically do finish projects. There's a lot of unfinished projects, but I typically do because the stress of having, like the completionist in me, the stress of it having it incompleted it is too stressful. And I've often wondered, like, how do you all do it? How to ADHDers who don't have the support of autism, like, do it? So, yeah, like finishing tasks, how do you navigate that? DONNA HENDERSON: So, when I'm doing something for other people, it's super helpful, like when other people are counting on me to get something done. MEGAN NEFF: And is the RSD, like, helping with that then? DONNA HENDERSON: For sure, for sure. And I think that's just part of my nature. And you know, what's important to me. Honestly, I get a lot of help. My husband has amazing executive functioning. I have terrible executive functioning. And so he makes a lot of decisions, he does most of our planning, and it works out really, really well for us. And I'm lucky, we didn't know this about each other when we got married, but it's worked out well. And at work, I used to try to manage my own schedule and I was a disaster. I made constant mistakes. I would triple-check something and still get it wrong. And I've just remembered, you know, Bill [INDISCERNIBLE 00:22:31] he wrote some great books. He's my mentor, and I once showed up at his house on a night when there was no meeting, no plan for me to be there. I literally walked in, like, "Hey." And he and his wife looked at me like, "What are you doing here?" I mean, that's how calendar-challenged I am. And so I finally accepted that. And so at work, I now have somebody who manages my schedule. And it takes all of the decision-making and planning off my plate. And I listened to your PDA episode and I heard you, you know, talk about you needing control over your schedule, that's the exact opposite of what I need. I love it when somebody else decides what my schedule will look like. And then I wake up in the morning, and they hand it to me, and I follow it. Yeah. MEGAN NEFF: [CROSSTALK 00:23:23] I wonder if, oh- PATRICK CASALE: Sorry. Well, it's interesting, that's- MEGAN NEFF: I'm curious if that's one of those subtle differences between ADHD and autism. Again, there'll be diversity, but like, yeah, my autistic daughter, it's like, what is the schedule? Let's make it together. Like, there's got to be urgency in creating the schedule. My ADHD is like, "Stop giving me decisions." Like, just give me breakfast. Like, just tell me what to wear. Just tell me what we're going to do today. So, I hadn't thought about that before. But like how we feel about our schedule and who's in control of it [CROSSTALK 00:23:59] subtle. DONNA HENDERSON: Yeah, it would be an interesting thing to think about. We'd have to sort out the non-PDA autistics from the PDA autistics, of course, and then, so many autistic people also have ADHD. So, it could be messy. But it's an interesting thing to think about, you know. And for me, you know, the important thing is, knowing that about yourself, and trying to set up your life to accommodate that and not judging yourself. Like, I used to get really frustrated with myself for being so bad at planning, and scheduling, and all that. And now it's another one of those things I can own and say, "Yeah, I'm terrible at that, and that's okay. I'm going to get help. You know? MEGAN NEFF: And that's the nice thing is if there's a lot- PATRICK CASALE: That was actually going to be my question.  MEGAN NEFF: Oh, go ahead. PATRICK CASALE: It's great, Megan and I are going to do this a lot today. That was going to be my question that you just answered Donna, was like, was there shame, and guilt, and frustration building up when, and initially it was like, why can't I do this? Why is this so challenging for me? DONNA HENDERSON: Yeah, yeah, and I just kept thinking, "Donna, come on, concentrate, concentrate, you know, stop being so distracted." And get so mad at myself. And obviously, it's embarrassing too, you know, walking into somebody's house and just, you know, the million and one times I just screwed up my schedule. And now I have to laugh at myself and I have to be okay. Dina Gassner said something really, really smart, wise, wise to me, once. Dina is an autistic researcher. And she wrote one of the forwards for one of my books, and she said, "The goal for any of us isn't independence, it's interdependence. It's understanding all the ways that you do and inevitably will depend on other people." And that's okay, right? MEGAN NEFF: I love that, I love that. Yeah, especially, in psychology, there's a lot of focus on the individual. And I'm writing a book right now, Self-care for Autistic People, just kind of funny because I have a weird relationship to the term self-care because I feel like so much pop psychology is self-care, but without that interpersonal relational lens that, like, we are interdependent. Like, we have always been, modernity gives us the illusion we're not. But we do best when we're actually supporting kind of interdependence. DONNA HENDERSON: Right, absolutely, yeah. I'm glad you're writing that book. I knew you were working on something. I didn't know it was that and I'm tired of all the self-care advice being exercise more, eat right, get enough sleep. Like, of course, those things are important, of course, they are. But you know, there's so much more to it than that. And those things are so hard for so many people, right? MEGAN NEFF: Yeah. For both ADHDers and autistic people, right? Like, if you think about the executive functioning that goes into any of those tasks you just listed. DONNA HENDERSON: Right, right, yeah. MEGAN NEFF: So, like… DONNA HENDERSON: Yeah, I'm going to try to think about how to say this without outing somebody. So, I have a challenging relationship with someone in my life who is not an immediate family member. And that person says hurtful things to me. And for years, I have then immediately, without thinking about it reacted and said things that I regret because I don't want to be hurtful or disrespectful, and also, because it just feels crappy when you lose it a little bit and say things you regret. And I've been working on paying attention to what's happening in my body when that person says hurtful things. And so, you know, recently that person said something hurtful, and I was able to just notice, oh, my heart rate just escalated. Wow, like, I hear sort of a whooshing sound in my ears, my muscles just tensed and I feel like I'm preparing for a fight. And I was aware of my body. And because I could do that, it allowed me the three seconds of grace I needed to not just say something, but to respond in a way that I was proud of. And to me, that's sort of the beginning of self-care, to be able to notice what the heck is happening with your own body, right? MEGAN NEFF: I love that. I love how you connected that, like, having that internal narrator of like I'm naming and narrating and, like, I sometimes call that self-attunement because we're attuning to ourselves. I love thinking about that as the basis of self-care. And I steal that from my book. I love that idea so much. DONNA HENDERSON: Absolute, yeah. And I'm sure I'm not the first person who made that connection. But when I think about self-care, yeah, but I love that phrase. That's the first step is you have to be attuned to what's going on with yourself, you know, before you can do anything else, you have to know you're tired before you try to get some sleep. You have to know you're hungry before you try to put some food in your body. It's pretty basic, MEGAN NEFF: Which gets back to that entire assumption, if it's not basic then nothing about self-care is basic, yeah. DONNA HENDERSON: Right, that's true. MEGAN NEFF: Can I… I don't know why I'm asking permission to diverge [INDISCERNIBLE 00:29:36]. DONNA HENDERSON: I know, right? MEGAN NEFF: Because I'm very cognizant of like, I feel like I'm talking a lot, but there's one piece I want to make sure I get on our conversation today. And this is a conversation, I don't know if you remember us having it. It was probably one of the first or second times you and I had met. So, there's this term context blindness. I don't like the term myself. I prefer, like, I'll talk about out high context communication that gets into anthropology, which is confusing, need for high context communication. But there's a conversation where I asked, like, I was saying how, you know, someone asked me like, what's my favorite book? I really struggle with this. Do you remember this conversation? DONNA HENDERSON: No, I don't. MEGAN NEFF: And okay, so I asked you, and I was saying how like, I would struggle with that because I'd be thinking about what bucket are we talking about? Are we talking about psychology buckets? Are we talking about fantasy books? Like, how do I possibly pick one favorite book? What's the context? And what you said, you were like, "Well, for me, if my neighbor was asking it, like this book would pop in my head. Whereas if I was at work, this book will pop in my head." And I remember asking you, "Like, you mean, you're not analytically like sifting through all that." And that was such an aha moment for me around, there's definitely something different for an ADHDer who's not also autistic around intuitively, I guess, picking up context cues would be the way to say that. DONNA HENDERSON: Yeah. So, my friend, Dr. Amara Brooke, who's a psychologist- MEGAN NEFF: Yeah, she's great. DONNA HENDERSON: Do you know… yeah, well, she once in a conversation with me called it context independence. So, I liked it. MEGAN NEFF: Oh, I like that term. DONNA HENDERSON: Right. It was too late, the book had already gotten to press. I couldn't stick it in the book. But I liked it. It's context independence, right? MEGAN NEFF: Yeah, because it doesn't depend on the context. I'm not going to change my authentic self based on the context. DONNA HENDERSON: Right, right. And so there's no right or wrong. There's two different ways of, sort of, moving through the world. And for non-autistic people, for the most part, well, everybody has top-down and bottom-up processing, right? So, I'm going to oversimplify, but for most non-autistic people, the top-down processing is prioritized. And so we take the context first. And here's the key, that happens for us subcortically, automatically, within milliseconds without our awareness. It just- MEGAN NEFF: And it's not through the prefrontal cortex, right? DONNA HENDERSON: Correct. It's subcortical, right? Correct. There's no awareness, there's no effort the overwhelming majority of the time. It just happens like magic, right? MEGAN NEFF: It's so [INDISCERNIBLE 00:32:25]. DONNA HENDERSON: But for most autistic people, there's more of a bottom-up processing where you have to take in all the details, get all the details, and sort of build up to the big picture from there. And, again, not better or worse, but there are different advantages and disadvantages to each style. And a huge, huge disadvantage to the context-independent style, the autistic style, is the time, and energy, and effort that it takes to move through all of that information when you're under pressure to respond to somebody, right? And so often, I get, you know, referrals for kids, or adolescents, or adults where everybody is saying, "We think they have slow processing speed." But on testing, their processing speed is just fine because testing does not require context. So, it's working tempo, it's conversational tempo that you might need extra time to build up to figure out the context. Does that make sense? MEGAN NEFF: Totally, yeah. I see something similar that often autistic people are deep processors, not slow processor. Like, we're processing so much so deeply that it takes more time. Yeah, absolutely. DONNA HENDERSON: Yeah, for sure, for sure. Especially, compared to, you know, a hyperactive impulsive style ADHDer like me, we tend to be fast, and, you know, I don't always go as deep. I'm capable of going as deep. But as I move through my day, it's not my natural way of being. MEGAN NEFF: So, in my first Venn diagram was putting autism and ADHD together. I put high-context communication in the middle because I talk with a lot of ADHDers where it feels like they share a lot of context to get to what I think neurotypical people might call the point. Like, how would you categorize that in the top down, bottom down? Or is that totally unrelated? And also, do you also observe that in ADHDers or on also autistic kind of a high context way of sharing stories or divergent to the point. DONNA HENDERSON: In the people I've known who are most context-independent or in the traditional term, you know, have the most context blindness, I haven't noticed, like, it would be interesting for me to go back and look how many of them also had ADHD, right? I think I might do that because that would be very, very interesting. And I've lost track of your question now. MEGAN NEFF: I love that. DONNA HENDERSON: I have no working memory. MEGAN NEFF: Like, if high context communication or like, in telling a story needing to share a lot of context, if that feels like an ADHD thing, or, again, maybe [CROSSTALK 00:35:20]- DONNA HENDERSON: No. MEGAN NEFF: …autism, that doesn't feel like maybe it's too- DONNA HENDERSON: No, to me that feels like if you don't intuitively have the context of what your listener already knows and actually needs to know or wants to know, you're at risk of giving too many details or too few details, right? And that happens sometimes too. MEGAN NEFF: All the time. Like, I do this, I hear this all the time. I either I'm sharing not enough or too much. Like magical Goldilocks of just enough information. DONNA HENDERSON: And to me as a non-autistic ADHDer, that's very intuitive. Like, how much detail to give someone in any given moment, and I'm not saying I, you know, get it right 100% of the time, obviously, but for the most part, it's pretty intuitive and easy for me to know that. And I've never had like a complaint about that. MEGAN NEFF: That's fascinating. I did think that was kind of an ADHD thing to, like, share long-winded, verbose stories that diverged all over the place. But that's really interesting to hear you say that. DONNA HENDERSON: Yeah, I think ADHDers, you know, sometimes we maybe talk a lot, or can be interrupting, or maybe go a little bit off-topic, but to have a pattern of providing too much what we would call irrelevant detail because that's really what you're talking about. I don't personally see that as an ADHD thing. It's not for me, it's not something I've noticed in my clients. PATRICK CASALE: Sometimes I wonder if that being an autistic trait, if it's also because you're trying so hard to read the other person's body language and facial expressions of how are they reacting to said information. And if I'm not getting the reaction that I think I should be getting, then I'm offering more and more and more information. And then I get lost in that explanation. And then I'm like, "Did that even make sense?" And the person is like, "No, I didn't track that at all." My wife will look at me and be like, "Why are you telling me all of this?" I'm like, "I was trying to figure out where the reaction was to what I was saying, and then, ultimately, I get lost in that." DONNA HENDERSON: And would it like feel natural for you or not to just like, what I would do in that moment is say, I can't read your reaction or I'm not sure if you want to hear more about this. Like, I would check in with the person verbally. PATRICK CASALE: No, I don't think that comes to mind immediately for me, when I'm in a conversation like that. I think it's just like, I get this anxious process that comes over me where I'm like, "Oh, my God, I don't know where to go from here. And now I feel trapped in this conversation." DONNA HENDERSON: And I wonder if that's, you know, partially just non-autistic conversations not being intuitive for you, and partially just having had bad experiences with conversations in the past, then they bring out that anxiety. And, like, so I don't happen to have either of those differences. And so for me, if I'm in a conversation, and I feel like wait, we're having a disconnect, the most natural thing is to be like, "Hey, I think we might be having a disconnect. What's going on? Like, what do you want? Do you want me to talk more or less? What's happening?" PATRICK CASALE: Save me a lot of time connecting. DONNA HENDERSON: Yeah. MEGAN NEFF: And I do that too, Donna. And I think I've trained myself, like I have developed a hypervigilance, and I think this is part of autistic ADHD masking, a hypervigilance to other people. So, for me, like, gaining psychological safety in conversation is knowing what's happening. So, I'll do a lot of like, "Okay, what's happening here?" The only therapists that I've actually worked well with was someone who was willing to do interpersonal work with me because I don't feel psychologically safe in a conversation unless I can check in with the other person and get an honest answer about what they're experiencing in that moment. DONNA HENDERSON: Yeah, that makes a lot of sense to me. And I think I've heard similar, you know, experiences from quite a lot of autistic people, late diagnosed autistic people, in particular, yeah, yeah. MEGAN NEFF: Yeah. Okay, small talk. Like, I've heard you talk about bread crumbs. You pick them up, like do you like small talk? Do you tolerate small talk? Like, I know you're good at it. DONNA HENDERSON: Yeah. So, I have to tell you this story. Sorry, I'm going to take a drink of water first. Sorry about that. So, I have a colleague who is autistic. And his name is Eric. And we've worked together for over a decade. And we work very well together. And I walked into his office one morning, I was in a big hurry. And I said, "Hey, the client you're seeing today…" And then I caught myself and said, "I'm sorry, that was so rude of me, how was your weekend?" And he laughed, and he was like, "Seriously, I do not need you to ask me about my weekend. I do that for you guys, meaning all of us non-autistic colleagues. And I'm good if we never ever do that again." And to be clear, like, I think Eric and I like really like each other and work very, very well together. But he's like, "There's no need to get into any of those social niceties." So, that was probably two, maybe three years ago. I cannot tell you how hard it is for me to like, engage my prefrontal lobe and stop my natural way of interacting when I see him and not say, "Hey, what's new? How's your daughter? What's going on? You're taking a vacation this summer?" It's so hard. MEGAN NEFF: But you're putting on a break to not do that. Like, for me and I think for Patrick, it's like forcing myself. It's like, I have to hit the gas to get myself to ask those damn questions that I really don't like. But for you, it's like putting on a break, it's holding something back. DONNA HENDERSON: That's exactly right. And I feel like it gives me this tiny little window into what it must be like to be autistic and to have to be, like, very aware in the moment of this is what my urge is to do in this situation. But this is what I must do if I want this situation to be comfortable for the other person. It's hard. And I only have one person I do that with. MEGAN NEFF: That's such a great example of the double empathy problem of like this two-way street of like, it's just a different cultural reference of how we're communicating. I had never thought about small talk that way as like, hard to hold it back. I have a lot more empathy all of a sudden for people. DONNA HENDERSON: Well, but most of us don't hold it back, right? I mean, it's just sort of unnatural. Like, if I see one of my neighbors, I'm like, I will cross the street in order to just make small talk for five or 10 minutes because for me, that's very… Patrick's laughing. PATRICK CASALE: [CROSSTALK 00:42:17] right now with my neighbor trying to do that to me the other day and me pretending not to hear them, and like getting in my car, and like backing out the driveway looking at them in the eye like… MEGAN NEFF: I literally cross the road. Like, if I see someone I'm I going to cross, I will cross the road, but I'll do it soon enough, so it doesn't look like I'm doing it to avoid them. But I will cross the road even to avoid eye contact. DONNA HENDERSON: Yeah, yeah. MEGAN NEFF: Like, just to avoid, like, any sensory experience of interacting with another human body. DONNA HENDERSON: All right, so I know you're supposed to be asking me questions. But may I ask you guys a question about this? MEGAN NEFF: Yeah, absolutely. DONNA HENDERSON: So, with my son, and he wouldn't mind me saying this, you know, as a non-autistic person, one of the ways I feel connected with other people is by connecting verbally, by talking. And it's not always deep and important. A lot of times it's, "So, what you're doing tonight? How was your day?" And kind of stuff, which is like the absolute last thing in the world he ever wants to do. And so the only way I've ever figured out of really connecting with him is to sort of go entirely to where he is. He loves military history, so like to go to a battlefield with him, to go to a battle reenactment with him, which is like my idea of hell. But I do it because like, that's… but I don't know, like how to bridge the gap so it's not, you know, one way or the other way, but that we can build some connection. You know what I mean? MEGAN NEFF: Absolutely, absolutely. First of all, I love that as a parent you're doing that. You're entering into their, I call it special interests, like our ecosystems, that you're entering into his ecosystem. Because you're right, like Patrick and I have talked about this a lot of, if you want to get access to the inner world of an autistic person, like entering through special interests. And I think a lot of parents who are trying to figure out how to connect with their autistic kids, I think that's often what they're doing. DONNA HENDERSON: Yeah. MEGAN NEFF: But yeah, it'd be nice for you not to have to go to like a historical event to connect with your son. And so, yeah, I think talking about it, like, and I don't know if there's a way of like talking about it without doing it. But that's often how, even if it's just to warm up the conversation, right? Because the questions are like, "What are you doing tonight?" Like, to me, that would be a sensory demand. But if the conversation has been warmed up through a special interest and then if we're able to then link to other things that, yeah, I think about it as a warm-up. And again, from a nervous system lens of like, if it's just a question that's invoking a deep response, that's a demand, my nervous system isn't warmed up for social interaction. But if it's been kind of melted and warmed through talking about something of interest, and then diverging to something that might feel more connecting for both of you, that's one approach I take. I don't know, Patrick, do you have thoughts on that? PATRICK CASALE: Yeah, I think that for people in my life, where I don't necessarily have safety, or I can be my true self around them, then that small talk, that demand, I'm going to shoot it down pretty quickly. And that's probably where I would really appreciate, you know, moving into the conversation through even a subset of the special interests or just something in general, that felt much more interest-focused. But for people who I have regular contact with, like, several of my best friends, my wife, etc., like, there's definitely small talk that goes on just because the relationship feels safe. And I also understand that that's what they need in a lot of ways in order to have some sort of reciprocity in the relationship. So, I'm not like freely giving it out, I'm not going out of my way to have it. But I'm certainly much more amenable to that. If my mom wants to call me right now. And like, say, "Hey, how was your weekend? How was your birthday?" I'd be like, "It was fine. It was fine." But it's just a very different relationship for me. So, I do think it matters for me, specifically, on the relationship, on the context of the relationship too, and the safety that has already been established in terms of just communication. And I think it's complicated. Like, there are definitely times where my wife is asking me questions. And I'm like, "I don't want to have like the small talk conversation with you right now". And I will be able to name that. Megan's been able to name that with me before when I said, "Hey, Megan, how was your day?" And she's like, "Stop asking me that." So, I think it's about being able to also ask for what you need in that moment. Like, hey, stop asking me that because that's not helpful here. This isn't where you have to interact that way, that's really helpful for me." DONNA HENDERSON: Right, right. And for me as a non-autistic person, it's also, I'm working on not thinking of there being a right way and a wrong way to interact. And it's really hard for me, it's really hard, yeah. PATRICK CASALE: For sure. MEGAN NEFF: It's hard to not think there's a right and a wrong way. DONNA HENDERSON: Yeah, I think my way is the right way. MEGAN NEFF: No, and don't we all as humans, too. DONNA HENDERSON: Sure, sure, yeah. MEGAN NEFF: Yeah. I'm like looking at the clock and now I'm feeling pressure of like, we should have some profound ending, I should have some profound question. Like, what is your favorite part about being an ADHDer? Or what is the hardest part? I don't know [CROSSTALK 00:47:56]- DONNA HENDERSON: I want to bring something, yeah- MEGAN NEFF: Yeah, go ahead. DONNA HENDERSON: No, there's no pressure because we're just going to do our awkward goodbye in a minute and it'll be excellent. But I want to bring up one thing that I wonder about is a difference, and obviously, everybody's an individual, but working memory, I think about. I've met so many autistic people who don't have ADHD, who have absolutely phenomenal working memory. Like, phenomenal working memory. MEGAN NEFF: Yes. DONNA HENDERSON: And I as an ADHDer have, like, absolutely terrible, terrible working memory. And for those of your listeners who aren't super familiar, I tell kids, it's the blackboard in your brain where you can write something down while you're working on it. And I write in disappearing ink on my blackboard. MEGAN NEFF: Same. DONNA HENDERSON: And, you know, one thing I've noticed, just with family members who have great working memories, they think a lot about the past and the future. And I am almost incapable of thinking about the past and the future. I just am very much in the moment and that leads to my difficulty with planning. And it's good and bad, right? They are so much better than I am at planning because they can hold the future in their brains. And, you know, think of different scenarios and choose the best scenario, which is very hard for me to do, but they also obsess a lot about the past and the future, which I don't tend to do. So, it's just something I've thought about as a difference. MEGAN NEFF: And that like, and I don't love this. I think, in general, we're going to find ways of moving away from ableist language but time blindness is how, like, that's often referred about of just the here and the now. And I love how you both see like what it gives you, but also what it takes from you, right? There is less of that obsessive. I think I've noticed that, too. I hadn't connected the obsessive tendency toward, you're right, that lack of lack of time blindness, but like that ability to perceive the future and the past definitely leaves us vulnerable. Somehow I managed to have both. I both struggle with time perception and my working memory is terrible. But I also do think a lot about the future and the past. DONNA HENDERSON: Well, maybe my theory is wrong, then. MEGAN NEFF: Well, I mean, maybe it's part of being an autistic ADHDer, maybe there's, yeah. DONNA HENDERSON: Yeah. MEGAN NEFF: Do you do both Patrick? PATRICK CASALE: I obsess about the past and the future constantly. And I'm a really good planner. I mean, I'm planning entire events, and retreats, or things that feel very natural to me. I really struggle moment to moment working memory where I will forget what I'm doing during the day all the time. I'll forget like, why I went down to the kitchen for something. I will forget like the three things that are in my mind that if I don't write them down immediately or respond to immediately they'll be gone. But everything else is constantly obsessing, and thinking about, and analyzing, and processing all the different alternative outcomes, so quite exhausting. MEGAN NEFF: Yeah, that's my experience too, what you just described. DONNA HENDERSON: As a non-autistic ADHDer, like, everything you just, I can't relate to that, that constantly, like planning, and obsessing, and running scenarios that you're… I'm like, "Oh, God, make it stop." Like, I just don't do that, which it's a blessing and a curse, right? PATRICK CASALE: For sure. And, you know, I've said it very often that I wish I could just turn it all off. Like, I wish I could just stop it. And yeah, definitely, it's exhausting. DONNA HENDERSON: It sounds exhausting. PATRICK CASALE: And on that really negative note, this has been fun. DONNA HENDERSON: I'll give you a quick positive, I don't want to end on a negative. Do I have time to do a quick positive- PATRICK CASALE: Yeah, sure, absolutely. DONNA HENDERSON: …so we don't end up… So, I tried stimulant medication a little bit over the past year, which I haven't really done in the past. And it really worked well for me in that it took away the urge to constantly move. I was able to sit still. I was able to get so much work done. But then I inevitably ended up with like a headache or my neck would be stiff, or my back would hurt. And I finally realized and I changed my internal narrative, my body is helping me out by wanting to move all the time. That's what my body needs. And I just need to lean into that and not try to fight who I am and my wiring. PATRICK CASALE: I love that. MEGAN NEFF: I love that. I love thinking through like, yeah, the ways your body and these things we call symptoms are actually working for you, and helping you out, and telling you what you need, yeah. PATRICK CASALE: Absolutely, yeah. Well, this has been a lot of fun and I wish that… I'm surprised like the hour went like that. And it was really, really great to have this conversation. I feel like we could have continuations of this for sure and go down so many different, like, areas and different perspectives. So, thank you so much for coming on and just sharing some of your story, too. DONNA HENDERSON: Well, thank you so much for having me. I agree, it went quickly and it was a lot of fun. PATRICK CASALE: Megan, you any got anything before I awkwardly sign us off? MEGAN NEFF: This is the part I get really awkward at. I'm so glad you came on Donna. Like, this has been, like, so fun to have this kind of hybrid clinical personal conversation. And thank you for your vulnerability. I know it is different to bring our lived experience to the conversation, especially, as clinical psychologists. We're kind of taught not to do that. So, thank you for being willing to do that. PATRICK CASALE: Totally. So, for everyone listening to the Divergent Conversations Podcast, new episodes are out every single Friday on all major platforms and YouTube. You can like, download, subscribe, and share. And Donna just made me realize while I was saying that we didn't give you any opportunity to share where they can find more of your work too. So, please feel free to- DONNA HENDERSON: Oh, okay. PATRICK CASALE: …share that as well. We'll put it in the show notes. DONNA HENDERSON: That would never have occurred to me actually. I'm the worst with that. My website is drdonnahenderson.com. And the website for the books is isthisautism.com. PATRICK CASALE: Perfect. All of that will be in the show notes so everyone has easy access as well. And now I don't know what else to say, so goodbye.

To contact Michelle Minette... Email: maminette@mamchlc.com Website: f-allthat.com FB Page: https://www.facebook.com/michelleaminettechlc ⁠⁠Website: www.clermontmentalhealth.com⁠⁠⁠⁠⁠⁠⁠⁠⁠ Email: snap@clermontmentalhealth.care Text: 513-655-6101 ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube Channel⁠⁠⁠⁠⁠⁠⁠⁠⁠ Instagram: @theofficialsnap FB Page: @mfriedmanlpcc ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠SNAP FB Group⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Twitter: @mfriedmanlpcc Mandy Friedman, LPCC-S, CCDVC, CCTP-II, CCMHC is a Licensed Professional Clinical Counselor, a Certified Clinical Domestic Violence Counselor, a Clinically Certified Trauma Professional and a Certified Clinical Mental Health Counselor. Mandy is the creator of the educational recovery program SNAP: Survivors of Narcissistic & Abusive Personalities. This program teaches survivors and concerned loved ones about abusive personalities, targets of abuse, abusive relationships and life in recovery from abuse. SNAP educational program of recovery helps empathic survivors of abuse fine tune and connect with their empathic nature in order to preserve, harness and protect the very things abusers seek to destroy. In her private practice, Clermont Mental Health, Mandy specializes in treating survivors of Cluster B personalities. She is also familiar with the role of addiction, substance abuse and self-harm in abusive relationships. Mandy's clients are often in need of trauma-informed care as part of their recovery. This has led her to specialize treating clients with Complex Post Traumatic Stress Disorder (C-PTSD). To help her clients, Mandy utilizes mindfulness based cognitive therapy (MBCT), cognitive behavioral therapy (CBT), psychoeducation and Polyvagal Theory. Mandy is a survivor of abuse and has first-hand knowledge of what survivors endure in abusive circumstances and living a healthy life after abuse. Disclaimer: This content is intended for educational purposes only. It is not a substitute for mental health treatment. It is important for survivors of abuse to find mental health professionals who understand trauma and abusive relationships. Please seek support from trusted and trained practitioners. This content is not meant to be used by anyone as diagnostic criteria. Permissions have not been granted for anyone to utilize this material as a source to make allegations about specific individuals. Any online content produced by SNAP: Survivors of Narcissistic & Abusive Personalities, Clermont Mental Health or Mandy Friedman LPCC-S is an educational discussion about narcissism which is a descriptive term for tendencies and behavioral patterns. Individuals with narcissistic features or tendencies do not necessarily meet DSM diagnostic criteria. The terms narcissistic and narcissism are used as descriptions of tendencies and behaviors and are not meant as clinical terms. --- Support this podcast: https://podcasters.spotify.com/pod/show/mandy-friedman-lpcc/support

Autism, Relationships & PDA (Pathological Demand Avoidance or Pervasive Drive for Autonomy The challenges people have maintaining relationships can be related to relational trauma, PDA, the desire for consistency and/or adherence to high or unrealistic expectations. PDA is a profile of autism, and people with PDA may have no problem making friends, but they may have difficulty keeping them. Can someone who is autistic become more flexible and lower their expectations if they want to? What elements are needed in relationships to accommodate for neurodivergence? CO-HOST Jen Perry, MSEd, MA, LPC  HIGHLIGHTS ·         The challenges faced in maintaining consistency and connection in friendship. ·         Autism and neurodiversity, and the importance of being aware of different types of neurodiversity. ·         The importance of consistency and pattern in the lives of neurodivergent people, and how it can relate to your emotional state. ·         The evolving nature of human experience and how things get put in and taken out of official stances. ·         TikToks that poke fun at the DSM and how it's revised. ·         The experience with ADHD and HSP, and how it relates to your emotional state. The importance of being aware of the current thought on certain topics, such as autism. ·         The challenges of being well-educated enough about certain topics, such as autism. ·         The importance of being intimate with different types of neurodiversity. ·         The importance of being fascinated by how we collectively as a culture and field talk about things. ·         The challenge of sharing your process without disenfranchising anyone or alienating anyone especially when talking about sensitive topics. ·         The challenges of studying and understanding neurodivergent experiences. ·         The importance of being aware of different types of neurodiversity, such as autism and HSP. ·         The importance of including autistic listeners in the conversation. ·         The importance of being aware of the imperfection of the process of studying and understanding neurodivergent experiences. ·         The importance of being aware of the evolving nature of human experience and how things are constantly changing. ·         How their autism shows up in their life. ·         The importance of being fascinated by how we collectively as a culture and field talk about things, while being aware of the challenges of studying and understanding neurodivergent experiences.  Personal insights about autism ·       Historically, they (Patricia) could be very self-centered and talk about her interests incessantly without realizing that not everyone is as fascinated by those things. ·         Patricia can have high and unrealistic expectations of how people should behave and how the world should be, which can lead to disappointment. ·         Patricia learned that she can change her rigid patterns of thinking and behavior with the help of a support system and feedback. Insights about how consistency and patterns show up in relationships ·       Relationships have an ebb and flow to them, with periods of high contact and periods of low contact. ·         The amount of contact in a relationship can be influenced by external factors, such as custody schedules or work demands. ·         Consistency and patterns in relationships can be important for some people, but not for others. ·         It's important to communicate with your partner about your needs and expectations for consistency and patterns in the relationship. ·         Consistency and patterns in relationships can change over time, and it's important to be flexible and adaptable. ·         It's important to have a support system outside of the relationship to help manage expectations and provide perspective. Information about PDA (Pathological Demand Avoidance or Pervasive/Persistent Drive for Autonomy ·         PDA is a clinical term that stands for pathological demand avoidance. ·         The term "pathological" is not liked by some people, as it implies that there is something wrong with the person. ·         PDA is characterized by a pervasive drive for autonomy, which means that the person needs to feel that they have a sense of efficacy over their life. ·         Demands can be either external or internal, and can cause stress and anxiety for people with PDA. ·         PDA can come up around internal demands, such as taking a shower or getting work done. ·         People with PDA may have a different experience of it depending on whether they are an internalizer or externalizer. ·         PDA is a profile of autism. ·         The clinical term for PDA is not liked by some people, as it implies that there is something wrong with the person. ·         People with PDA may have experienced relational trauma, which can make it difficult for them to feel safe and secure in relationships. ·         People with PDA may have difficulty with demands and expectations, and may need to have a sense of control over their environment to feel safe. ·         PDA is a complex condition that requires a nuanced understanding of the individual's experience. ·         People with PDA may benefit from support and understanding from others, as well as strategies for managing demands and expectations. ·         PDA is just one aspect of the neurodiversity spectrum, and it is important to be aware of the different types of neurodiversity and how they can affect people's lives. ·         People with PDA may have unique strengths and abilities, and it is important to recognize and celebrate these strengths. ·         PDA is a complex condition that requires a nuanced understanding of the individual's experience, and it is important to be aware of the challenges and opportunities that come with it. PODCAST HOST Patricia was a Licensed Clinical Social Worker, but is now exclusively providing coaching. She knows what it's like to feel like an outcast, misfit, and truthteller.  Learning about the trait of being a Highly Sensitive Person (HSP), then learning she is AuDHD (ADHD and autistic) helped Patricia rewrite her history with a deeper understanding, appreciation, and a sense of self-compassion.  She created the podcast Unapologetically Sensitive to help other neurodivergent folks know that they aren't alone, and that having a brain that is wired differently comes with amazing gifts, and some challenges.  Patricia works online globally working individually with people, and she teaches Online Courses for HSPs that focus on understanding what it means to be an HSP, self-care, self-compassion, boundaries, perfectionism, mindfulness, communication, and creating a lifestyle that honors you CO-HOST BIO Jen Perry, MSEd, MA, LPC has been a psychotherapist for 20 years. She specializes in helping Highly Sensitive People thrive in love, work, and parenting Highly Sensitive Children. Jen is passionate about using mindfulness and compassion-based approaches to ameliorate human suffering. LINKS Jen's Links Email: Jen@heartfulnessconsulting.com Jen's website: https://heartfulnessconsulting.com/ Patricia's Links HSP Online Course--https://unapologeticallysensitive.com/hsp-online-groups/ Receive the top 10 most downloaded episodes of the podcast-- https://www.subscribepage.com/e6z6e6 Sign up for the Newsletter-- https://www.subscribepage.com/y0l7d4 To write a review in itunes: click on this link https://itunes.apple.com/us/podcast/unapologetically-sensitive/id1440433481?mt=2 select “listen on Apple Podcasts” chose “open in itunes” choose “ratings and reviews” click to rate the number of starts click “write a review” Website--www.unapologeticallysensitive.com Facebook-- https://www.facebook.com/Unapologetically-Sensitive-2296688923985657/ Closed/Private Facebook group Unapologetically Sensitive-- https://www.facebook.com/groups/2099705880047619/ Instagram-- https://www.instagram.com/unapologeticallysensitive/ Youtube-- https://www.youtube.com/channel/UCOE6fodj7RBdO3Iw0NrAllg/videos?view_as=subscriber Tik Tok--https://www.tiktok.com/@unapologeticallysensitiv e-mail-- unapologeticallysensitive@gmail.com Show hashtag--#unapologeticallysensitive Music-- Gravel Dance by Andy Robinson www.andyrobinson.com

* Mets-toi en présence de Dieu, pour essayer de Lui parler. * Tu disposes de 10 minutes, pas plus : va jusqu'au bout, même si tu te distrais. * Persévère. Prends ton temps et laisse l'Esprit Saint agir “à petit feu”. Un passage de l'Évangile, une idée, une anecdote, un prêtre qui s'adresse à toi et au Seigneur, et t'invite à entrer dans l'intimité de Dieu. Choisis le meilleur moment, imagine que tu es avec Lui, et appuie sur play pour commencer. Toutes les infos sur notre site : 10minutesavecjesus.org Contact : 10minavecjesus@gmail.com DSM

To access the full episode and our conference library of 200+ fascinating psychology talks and interviews (with certification), please visit: https://twumembers.com In this interview, I'm joined by Dr David Spiegel. Dr. Spiegel is an author, psychiatrist and professor at Stanford University, and one of the world's leading experts into the clinical applications of hypnosis. He has published thirteen books, over 400 scientific articles, and 170 chapters on hypnosis, stress physiology, trauma, and psychotherapy. In this conversation, we discuss: — Dr Spiegel's groundbreaking research into how hypnosis can be applied in a clinical setting to improve client outcomes — What's happening in the brain during hypnotic states of mind — A simple test for identifying if you are hypnotisable or not — Why hypnosis can be a powerful treatment for trauma And more. You can learn more about Dr Spiegel's Self Hypnosis Reveri App by going to www.reveri.com. --- This session was recorded as part of our Holistic Psychotherapy Summit in January 2023. To access the full conference package, as well as supporting materials, quizzes, and certification, please visit: https://holisticpsychotherapysummit.com. --- Dr. David Spiegel is Willson Professor and Associate Chair of Psychiatry & Behavioral Sciences, Director of the Center on Stress and Health, and Medical Director of the Center for Integrative Medicine at Stanford University School of Medicine, where he has been a member of the academic faculty since 1975, and was Chair of the Stanford University Faculty Senate from 2010-2011. He has published thirteen books, over 400 scientific journal articles, and 170 chapters on hypnosis, psychosocial oncology, stress physiology, trauma, and psychotherapy. His research has been supported by the National Institute of Mental Health, the National Cancer Institute, the National Institute on Aging, the National Center for Complementary and Integrative Health, the John D. and Catherine T. MacArthur Foundation, the Fetzer Institute, the Dana Foundation for Brain Sciences, and the Nathan S. Cummings Foundation. He was a member of the work groups on stressor and trauma-related disorders for the DSM-IV and DSM-5 editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. He is Past President of the American College of Psychiatrists and the Society for Clinical and Experimental Hypnosis, and is a Member of the National Academy of Medicine. In 2018, Dr Spiegel was invited to speak on hypnosis at the World Economic Forum in Davos in 2018. --- Interview Links: — www.reveri.com — Trance and Treatment: Clinical Uses of Hypnosis - Herbert Spiegel and David Spiegel https://amzn.to/3yKxA4K --- 3 Books Dr Spiegel Recommends Every Therapist Should Read: — Wherever You Go, There You Are - Jon Kabat Zinn - https://amzn.to/3P8rQa9 — Studies on Hysteria - Sigmund Freud - https://amzn.to/3ORL8B6 — When Nietzsche Wept - Irvin Yalom - https://amzn.to/3al0JKt

In today's episode, I take you behind the curtain of getting assessed for ADHD.  This is my personal experience and everyone's experience is slightly different but in general, this will help you understand what to expect. *I discuss the reasons why to get assessed (in case it ISN'T ADHD and there is another possible source for your symptoms. *I share a few different resources for you to use that are SOLID resources (not just pseudoscience). *I tell the story of my assessment from beginning to end and what I experienced during my meeting with the psychiatrist and the kind of ADHD that I personally have. *What are the 3 types of ADHD and what each one looks like. *What is the DSM-5 and why it's behind the times when it comes to ADHD and ADHD research. p.s. Just in case you haven't heard this today...I see you. I love you. And I'm rooting for you. Always.Resources for ADHD Resources and Assessments: ADDitudemag.comhttps://directory.additudemag.com/https://chadd.org/National Resource Center on ADHD: https://chadd.org/about/about-nrc/ DSM- 5https://www.psychiatry.org/psychiatrists/practice/dsm Want to connect with me?*Subscribe to my Piece Of Mind Love Note here:https://www.karrieoutloud.com/about*Take my ADHD Quiz For Women here: https://www.karrieoutloud.com/adhd-quiz (not a diagnostic tool - help you see if you should get assessed by a professional) *My website: karrieoutloud.com*My Instagram: @karrieoutlou

On today's episode we have pleasure activist and cultural sexologist Dr. Carol Queen, Ph.D (She/They) join us for a conversation about embracing the diverse world of sexuality and relationships. Together we talk about how the values of anarchism intersects with our pleasure, pop sex-positivity vs deep sex-positivity, and how we need to work both within and against the systems. If you enjoyed today's podcast, then please subscribe, leave a review, or share this podcast with a friend! To learn more, head over to the website ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠www.modernanarchypodcast.com⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ And if you want to connect deeper with the Modern Anarchy Family, then join the movement by becoming a part of the conscious objectors ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠patreon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Your support is what powers this work and the larger societal change we are creating! Let's continue to challenge our assumptions and grow together. Join the community here: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.patreon.com/user?u=54121384⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Intro and Outro Song: Wild Wild Woman by Your Smith Modern Anarchy Community: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ : www.modernanarchypodcast.com ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ : https://www.instagram.com/modernanarchypodcast ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Patreon⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ : https://www.patreon.com/user?u=54121384 Carol's Community: Carol Queen PhD is a writer, cultural sexologist, theorist of deep sex-positivity, Good Vibrations Staff Sexologist, and the co-founder and director of the Center for Sex & Culture in San Francisco. Twitter: https://twitter.com/carolqueen Instagram: https://www.instagram.com/carolqueenphd/ FB public page: https://www.facebook.com/carolqueenauthor Website: www.carolqueen.com Good Vibrations : https://www.goodvibes.com/content/c/good-vibrations-sexologist-carol-queen Resources to Learn More: BDSM Versus the DSM : https://www.theatlantic.com/health/archive/2015/01/bdsm-versus-the-dsm/384138/ BDSM related fantasies were found to be common (40-70%) in both males and females, while about 20% reported engaging in BDSM: https://www.tandfonline.com/doi/full/10.1080/00224499.2019.1665619#:~:text=BDSM%20related%20fantasies%20were%20found,20%25%20reported%20engaging%20in%20BDSM. Exhibitionism for the Shy : https://bookshop.org/a/88413/9780940208353 Go the Way Your Blood Beats: On Truth, Bisexuality and Desire : https://bookshop.org/a/88413/9781910924716

Sensory Diet Digital Course SALE Starts October 16, 2023October is Sensory Processing Disorder (SPD) Awareness Month. SPD is a condition that affects how the brain processes and responds to sensory information from the environment and the body.Individuals with SPD may have difficulty regulating and interpreting sensory input, such as touch, sound, taste, smell, and movement. This can lead to challenges in daily life, affecting their ability to engage in activities, interact with others, and navigate their surroundings. SPD can occur in both children and adults and is often seen in conjunction with other conditions such as autism,, ADHD, or developmental delays. It is important to note that SPD is not officially recognized as a standalone diagnosis in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), but it is commonly acknowledged and studied within the field of occupational therapy and sensory integration.In this episode, we dive into 10 facts about SPD, including what type of disorder it is, who can struggle with it, comorbidities, and more! Make sure to check out all of our links below! Looking for more in-depth help? Sign up for 2-on-1 Mentoring With Us!!We'd love to answer your questions on the podcast! Fill out this form -> https://harkla.typeform.com/to/ItWxQNP3 Brought To You By HarklaThis podcast is brought to you by Harkla.  Our mission at Harkla is to help those with special needs live happy and healthy lives. We accomplish this through high-quality sensory products & child development courses.Podcast listeners get 10% off their first order at Harkla with the discount code "sensory". Head to Harkla.co/sensory to start shopping now.LinksAll Things Sensory Podcast Instagram Harkla YouTube ChannelHarkla Website - Shop Sensory Products!Harkla InstagramSensational Kids (book)STAR Institute Sensational Brain Sensory ChecklistsEp 248 Will My Child Grow out of SPD?Ep 13 Should I Get My Child a Diagnosis?Ep 231 Sensory Integration Basics

Bradley Lewis works at the intersections of medicine, psychiatry, philosophy, the psychological humanities, mad studies, and disability studies, balancing roles as both a humanities professor and a practicing psychiatrist. Lewis earned degrees in psychiatry (MD) and Interdisciplinary Humanities (PhD) from George Washington University, and he currently holds an associate professorship at New York University's Gallatin School of Individualized Study. He also has affiliations with NYU's Department of Social and Cultural Analysis, the Department of Psychiatry, and the Disability Studies Minor. Additionally, he serves on the editorial board of the Journal of Medical Humanities. His books include Moving Beyond Prozac, DSM, and the New Psychiatry: The Birth of Postpsychiatry, Narrative Psychiatry: How Stories Shape Clinical Practice, and Depression: Integrating Science, Culture, and Humanities. He has two books forthcoming: Experiencing Epiphanies in Literature and Cinema and a co-edited Mad Studies Reader. His writing offers unique insights into the hegemonic foundations of mental health and champions the role of narrative in therapy. His work also actively bridges the gap between academia and on-the-ground initiatives. A founding member of the Institute for the Development of Humane Arts (IDHA), Lewis champions a paradigm shift in mental health by facilitating collaboration between advocates, service users, and clinicians. His profound appreciation for the humanities guides his exploration of mental health, often through the lens of art and literature. By analyzing the lives of figures like Vincent Van Gogh or dissecting Chekhov's narratives, Lewis encourages us to rethink and expand our understanding of psychological experiences. Join us as we explore the philosophical foundations, practical implications, and transformative potential of his work. *** Thank you for being with us to listen to the podcast and read our articles this year. MIA is funded entirely by reader donations. If you value MIA, please help us continue to survive and grow. Mad in America podcasts and reports are made possible, in part, by a grant from the Thomas Jobe Fund. To find the Mad in America podcast on your preferred podcast player, click here