Podcasts about DSM

Send us a textUna de las películas más exitosas de todos los tiempos será el punto de partida de un complejo relato que aborda los límites de la locura y las complejidades del diagnóstico en siquiatría. En paralelo revisaremos la historia de uno de los estudios más audaces del siglo XX, uno que remeció a toda una disciplina y desencadenó cambios profundos en ella. Hoy, gracias a una investigación periodística, sabemos que ese estudio tiene importantes grietas y tal vez su historia es más potente que sus datos.Support the show

If you or your partner are navigating the aftermath of infidelity and wondering whether the sexual behavior involved was really “sex addiction,” this episode is a must-listen. In Episode 86, I'm unpacking one of the most common and confusing questions couples face after betrayal: Is it sex addiction—or is something else going on? We'll explore: Why “sex addiction” is not a recognized mental health diagnosis in the DSM-5 The risk of mislabeling sexual behavior and missing the deeper emotional drivers What the Out of Control Sexual Behavior (OCSB) model is and why it offers a more compassionate, effective path forward Actionable next steps for couples dealing with out-of-control sexual behavior—including excessive porn use or secretive sexual activity This episode is especially supportive for couples who want to move beyond shame, blame, or one-size-fits-all labels and into real, values-based healing.

On today's podcast, Luis discusses his personal journey with trauma and nutrition, and how the two together have an impeccable ability to help people recover from stress and trauma.Luis shares his full personal story of childhood abuse, and how food was the only thing that could suppress and repress his pain. His personal experiences drew him towards a psychology degree, which he abandoned because of his dislike of the DSM and it's diagnostic rigidity. Simultaneously, he was working at a health food store, and began to see how much could be changed, both in himself and others, through dietary changes. When he began studying somatic psychology, Luis discovered the missing piece he had been searching for: how trauma is what prevents people from sticking to specific diets that could help people recover from certain health conditions.Certain foods and eating habits can allow us to tolerate the intolerable, and can become a dependence in order for us to relax, sleep, work, and more. In the Embodied Nutrition group, Luis teaches how foods can stimulate, depress, or balance the nervous system, and how to relate to the emotions and sensations arise when we practice "food sobriety."You can read more about, and register for, the Living Seasonally & Cyclically webinar here: https://www.holisticlifenavigation.com/events/living-seasonally-cyclically-how-i-recovered-from-burnout You can read more about, and register for, the 6-month Embodied Nutrition group here: https://www.holisticlifenavigation.com/slow-practice-nutrition-group----You can learn more on the website: https://www.holisticlifenavigation.com/ Learn more about the self-led course here: https://www.holisticlifenavigation.com/self-led-new Join the waitlist to pre-order Luis' book here: https://www.holisticlifenavigation.com/the-book You can follow Luis on Instagram @holistic.life.navigationQuestions? You can email us at info@holisticlifenavigation.com

Anthony Williams details how his Xanax addiction led him to crime, his arrest, and a 7-year prison sentence in Arizona. #XanaxAbuse #PrisonSentence #TrueCrime #AddictionCrisis #LegalTroubles #OvercomingAddiction #JusticeSystem #lifelessons Thank you to LUCY for sponsoring today's episode: Let's level up your nicotine routine with Lucy.  Go to HTTP://LUCY.CO/IANBICK and use promo code (IANBICK) to get 20% off your first order. Lucy has a 30-day refund policy if you change your mind.  Connect with Anthony Williams: Website: https://www.algamus.org/ Tiktok: https://www.tiktok.com/@tony.scott_?_t=ZT-8to9i8aIsH8&_r=1 Instagram: https://www.instagram.com/tony.scott.music?igsh=OTRjMHl0ZW1hNjA0&utm_source=qr Instagram: https://www.instagram.com/algamus_az?igsh=OXlsazhiY3BzMGJm Hosted, Executive Produced & Edited By Ian Bick: https://www.instagram.com/ian_bick/?hl=en https://ianbick.com/ Presented by Tyson 2.0 & Wooooo Energy: https://tyson20.com/ https://woooooenergy.com/ Buy Merch: https://convictclothing.net/collections/convict-clothing-x-ian-bick Timestamps: 00:00:00 Escaping Arizona's Warm Winters 00:04:32 Overcoming Cultural Pressure and Family Influence 00:09:10 Struggles with Education and Substance Use 00:14:04 Parental Denial and Addiction Struggles 00:18:14 A Desperate Deal with Law Enforcement 00:23:02 From Rehab to Arrest: The Turning Point 00:27:50 Impact of Crime on Small Town Community Life 00:32:37 Experiencing Racial Segregation in Jail 00:37:14 The Reality of Politics in Prison 00:41:50 Insight into the Moderate Treatment Program 00:46:30 Surviving Solitary Confinement in Arizona 00:51:21 Career Transition: From Electrician to Treatment Program 00:56:12 The History and Evolution of a Gambling Treatment Program 01:01:10 Understanding Gambling Addiction: Treatment and Challenges 01:05:52 Understanding Problem Gambling and the DSM-5 Criteria 01:10:43 Overcoming Insecurities and Building Self-Confidence 01:15:10 Networking and Collaboration Opportunities Powered by: Just Media House : https://www.justmediahouse.com/ Creative direction, design, assets, support by FWRD: https://www.fwrd.co Learn more about your ad choices. Visit megaphone.fm/adchoices

Summary  At age 67, Wendy Cole transitioned from male to female after a lifetime of hiding her true identity. In this candid conversation, Wendy shares the emotional cost of repression, her turning point in 2014, and how she found joy, health, and purpose by finally embracing who she is. Now a mentor and advocate, Wendy is helping others navigate their own gender journeys and working to humanize what it means to be transgender.  Keywords  transgender, coming out, identity, support, mental health, community, authenticity, transition, LGBTQ+, personal growth  Takeaways  Wendy transitioned male to female at age 67.She felt a lifelong sense of not belonging.Gender identity is formed in the brain during the second trimester.Wendy faced significant societal and familial pressure to conform.She repressed her identity for decades due to fear and shame.The DSM's classification of LGBTQ+ identities has evolved over time.Wendy found support and community later in life.She emphasizes the importance of living authentically.Wendy's mission is to educate others about transgender experiences.It's never too late to pursue one's true identity.Sound Bites  "I was punished for breaking my glasses.""I was taken to a psychiatrist.""I was threatened with being committed.""I couldn't take it anymore.""I was doing this out of survival.""I was pretty much on my own.""I was going to do this for me.""It's never too late to take charge."Audio Chapters   00:00  Wendy's Journey of Self-Discovery11:58  The Struggles of Repression and Acceptance22:15  Transitioning and Finding Community32:29  Living Authentically and Educating Others  More About Wendy Cole:   http://meetwendycole.com/https://wendycolegtm.net/category/podcasts/Demystifying the Transgender Journey Podcast: https://wendycolegtm.net/episode-001-demystifying-this-podcast/Podcast website and resources: https://www.OutLateWithDavid.com  YouTube Edition:    https://youtu.be/eU5v97dHNIs YouTube Channel:   https://www.youtube.com/channel/UCvsthP9yClKI4o5LxbuQnOg  Certified Professional Life Coach, David Cotton:  https://www.DavidCottonCoaching.com  Contact David: mailto:david@davidcottoncoaching.comhttps://www.DavidCottonCoaching.comhttps://www.OutLateWithDavid.comhttps://linktr.ee/davidacotton  © 2025 David Cotton Coaching, LLC. All rights reserved. The "Out Late With David" podcast and its content are the property of David Cotton Coaching, LLC. Unauthorized use and/or duplication of this material without express and written permission from David Cotton Coaching, LLC is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to "Out Late With David" and David Cotton Coaching, LLC with appropriate and specific direction to the original content.  

In this episode of Authentically ADHD, Carmen peels back the curtain on Cognitive Disengagement Syndrome (CDS)—sometimes called Sluggish Cognitive Tempo—to reveal why so many of us with ADHD feel stuck in a fog of daydreams, slow processing, and low energy. After a quick, relatable anecdote about spacing out in a meeting (and the panic that follows), we dive into what CDS actually is: a cluster of symptoms that overlaps with ADHD but isn't the same thing. You'll learn how CDS shows up differently than classic inattentive ADHD—think mental “brakes,” mind-wandering marathons, and that overwhelming sense that your brain is running underwater.Next, we explore how CDS can silently sabotage work, relationships, and self-esteem. Carmen shares listener stories—like the person who's constantly five steps behind in conversations or the professional whose “slow load time” makes presentations feel like climbing Everest. We unpack the neuroscience in digestible terms: what brain networks are under-activated, how dopamine dysregulation plays a role, and why meds that help “hyperactive” ADHD often fall short for CDS symptoms.Finally, we shift to practical strategies. You'll walk away with at least three tangible tools to test—everything from micro-bursts of movement to reframing your to-do list in ultra-small steps and scheduling “CDS-friendly breaks” before burnout sets in. By the end, you'll understand that those moments of mental fog aren't personal failings but part of a hidden ADHD subprofile—and you'll have a roadmap for bringing more focus, energy, and self-compassion into your lifeShow Notes: IntroductionHello and welcome! Today, we're diving into a fascinating and often underrecognized topic: Cognitive Disengagement Syndrome, or CDS. If that name doesn't ring a bell, maybe its older label will — Sluggish Cognitive Tempo. (Yeah, I know, it sounds like an insult you'd hurl at a slow computer.) In this episode, we're pulling back the curtain on what CDS really is, why it's not just “laziness” or ordinary daydreaming, and why experts say it deserves far more attention than it gets.Hook: Ever feel like your brain is running on dial-up internet in a high-speed world? You're trying to focus, but it's like there's a fog inside your head, and everything is moving in slow motion. Your thoughts wander off like they've got a mind of their own, and snapping back to reality is a bit like wading through molasses. If you're nodding along (or if someone you know comes to mind), you might be familiar with what we're talking about. And if you have ADHD or work with folks who do, you might have seen hints of this “slow-mo” attention state that often hides in plain sight.In this 25-30 minute episode, we'll cover: what exactly Cognitive Disengagement Syndrome is and its key symptoms (in plain, relatable language), how it overlaps with but isn't the same as ADHD, why it often gets misdiagnosed as something else (like depression or anxiety), and some practical, real-world tips for managing it. All of that with a professional tone and a little bit of sass — because learning should be engaging, right? So grab a coffee (you might need it for this topic!), and let's get started.What Is Cognitive Disengagement Syndrome (CDS)?All right, first things first: what on Earth is Cognitive Disengagement Syndrome? In a nutshell, CDS is a term that describes a unique set of attention symptoms — think of it as a “cousin” to ADHD, but with its own personality. It used to be known as “Sluggish Cognitive Tempo,” which frankly sounds like your brain is a slow turtle. No surprise, experts decided to rebrand it to something less snarky and more accurateen.wikipedia.orgmedvidi.com. Now we call it Cognitive Disengagement Syndrome, highlighting how the mind can seem to disengage from the task at hand.So what does CDS look like? Picture a person (child or adult) who is constantly drifting off into their own world. We're talking excessive daydreaming, blank staring, zoning out as if the lights are on but nobody's homeadditudemag.com. Their mind wanders like it's on an aimless road trip. They might appear mentally foggy, sluggish in their movements or thinking, and often slow to respond to what's happening around themedgefoundation.org. Folks with CDS often seem underactive – the opposite of hyperactive – and may be described as lethargic or low energy. You might notice them blinking awake as if they were literally about to nod off, even during activities that aren't boring for everyone else. In short, their alertness is inconsistent: one moment they're tuned in, but the next they've drifted away on a cloud of thoughtsedgefoundation.org.Another hallmark is being easily confused or mentally “fogged.” It's not that they can't understand things, but their processing speed is slow. Imagine trying to stream a video with a weak Wi-Fi signal – the content eventually comes through, but it lags. Similarly, a person with CDS might take longer to process information or retrieve memories, leading them to lose their train of thought oftenen.wikipedia.org. They might say, “Wait, what was I doing?” more times a day than they'd like.And here's a term researchers use that really nails it: being “internally distracted.” With classic ADHD, people are often pulled by external distractions (every noise, sight, or squirrel outside the window steals their attention). But with CDS, the distraction is coming from inside their own mind – an internal daydream or just a blank fog that is surprisingly hard to shakechadd.org. It's like their mind's “attention switch” is set to the off position when it should be on. They may appear withdrawn or apathetic, not because they don't care, but because their brain isn't fully engaging with what's in front of iten.wikipedia.org. This has led others to mislabel them as “lazy” or “not trying hard enough,” which is pretty unfair. In reality, CDS is a genuine attentional problem – one that's different from typical ADHD and definitely not a character flawpubmed.ncbi.nlm.nih.gov.Let me give you a relatable example: Think about those mornings when you just can't wake up, and you stumble around in a coffee-deprived haze. You pour orange juice into your coffee mug and put your car keys in the fridge – your brain just isn't firing on all cylinders. That's a bit what CDS feels like all day long for some people. They're awake, but there's a persistent grogginess or dreaminess that makes every mental task feel like lifting weights in Jell-O.Now, you might be wondering how common this is. Research suggests that CDS symptoms are not rare at all. In fact, it's estimated that a significant chunk of people with ADHD – up to 40% of kids, by some estimates – also experience these CDS-type symptomsadditudemag.com. And it's not just in kids. Adults can have CDS as well (even if they never knew it had a name). It's been observed in roughly one-third of adults diagnosed with inattentive ADHD, for exampleedgefoundation.org. There are even cases of people who only have CDS without the more classic ADHD traits – they might have gone through life just labeled as the “spacey” or quiet ones.One important note: CDS is not officially listed as a diagnosis in the DSM-5, the big manual of mental disordersadditudemag.com. That means your doctor won't find “Cognitive Disengagement Syndrome” as a formal label to bill your insurance. But don't let that fool you into thinking it's not real. The concept has been studied by psychologists for decades, and there's a consensus in recent research that these symptoms cluster together in a meaningful wayadditudemag.compubmed.ncbi.nlm.nih.gov. In other words, something is going on here beyond just normal variation in attention. So even if it's not an official diagnosis yet, many clinicians recognize CDS (or SCT) as a very useful description for patients who have this particular profile.To summarize this segment: CDS, formerly known as sluggish cognitive tempo, refers to a pattern of chronic daydreaming, mental fog, slow processing, and low initiative that can seriously affect daily life. It's like the brain's engine is always idling in neutral – not because the person is willfully tuning out, but because their brain's ability to engage is, for lack of a better word, sluggish. Now that we know what it is, let's talk about how this compares to a condition you've definitely heard of: ADHD.How Does CDS Overlap with and Differ from ADHD?If you listened to that description of CDS and thought, “Hmm, some of that sounds like ADHD,” you're absolutely right. CDS has a lot of overlap with ADHD, especially the inattentive type. Both involve problems with attention, forgetfulness, and maybe looking off into space when you're supposed to be working. In fact, for years CDS (back when it was called SCT) was thought of as possibly just a subtype of ADHD. Many people with ADHD do have some CDS symptoms and vice versaedgefoundation.org. But here's the kicker: modern research indicates that CDS and ADHD aren't identical – they're more like siblings than twinsen.wikipedia.org. They share some DNA, but each has its own quirks.Let's start with the obvious difference: hyperactivity (or rather, the lack of it). ADHD famously often comes with hyperactivity and impulsivity (at least in the combined or hyperactive-impulsive presentations). Those are the folks who are fidgeting, tapping, jumping out of their seats, acting on impulse – their internal motor runs fast. In contrast, people with pure CDS are the polar opposite of hyperactive. Remember, another term for this was “sluggish” cognitive tempo. Instead of bouncing off the walls, someone with CDS might be melting into the wall, so to speak – quiet, slow-moving, and passiveen.wikipedia.org. They're not blurting out answers in class; they're the ones who may not answer even when you call on them, because their mind was elsewhere. One researcher humorously noted it's like comparing a race car (ADHD) to a slow cruiser (CDS) – one's got too much go, the other not enough.Attention differences: Both ADHD and CDS involve attention problems, but the type of attention problem differs. Here's a way to think about it: people with ADHD can engage their attention quickly but struggle to sustain it, especially if something isn't interesting – their attention is like a spotlight that flickers on exciting things but then fizzles outen.wikipedia.org. On the other hand, people with CDS have trouble even getting that spotlight to turn on and lock onto the target in the first placeen.wikipedia.org. It's as if the brain's ignition switch is delayed. Once they do focus, they might actually be able to stick with it a bit (especially if it's something captivating), but the hard part is that initial spark of attention. An ADHD student might start their homework and then get distracted by 10 different thoughts and leave it unfinished, whereas a CDS student might sit down to do the homework and spend 30 minutes in a haze, kind of staring at the page not even knowing where to begin. Both end up with not much done, but the mental experience is different.Another difference is processing speed and accuracy. ADHD folks can often think quickly (sometimes too quickly, leading to impulsive mistakes). But someone with CDS processes information more slowly and may be prone to more mistakes because their attention to detail is decoupled or laggingen.wikipedia.orgen.wikipedia.org. Think of it this way: if an ADHD brain is like a flashy smartphone that sometimes loses signal, a CDS brain might be like an older phone that has a constant delay – slower to open apps and occasionally freezes on a screen. Both might drop your call (metaphorically speaking) but for different technical reasons.Memory and retrieval can also feel different. ADHD's inattention often looks like forgetfulness due to distraction (you didn't remember the meeting because you were busy thinking about five other things). In CDS, forgetfulness might come from that fog – the information just never fully registered or gets stuck behind a mental cloud. People with CDS often say they feel like they have a “brain fog” or that they're in a constant daydream, which isn't typically how someone with classic ADHD would describe their attention (they might say theirs is like a ping-pong ball bouncing around).Now let's talk mood and motivation overlaps. ADHD is frequently linked with externalizing behaviors – meaning, some with ADHD might have impulsive anger outbursts, act without thinking, maybe develop conduct issues, or lean toward thrill-seeking. CDS, conversely, is more often linked with internalizing tendencies: anxiety, shyness, even depressive feelingsen.wikipedia.orgen.wikipedia.org. Why? Possibly because being in a fog and struggling quietly can dent your self-esteem or make social life harder, leading to withdrawal. A kid with ADHD might be the class clown or the one getting in trouble; a kid with CDS is more likely to be the wallflower in class who barely says a word. Studies consistently find that CDS-prone individuals are often socially withdrawn and shy, sometimes getting overlooked or ignored by peersen.wikipedia.org. People might think they're aloof or uninterested, but in reality the person is just slow to respond and not catching the fast-paced flow of conversationen.wikipedia.org. Meanwhile, ADHD kids are hard to ignore – they demand attention, sometimes in not-so-great ways, and can get actively rejected due to disruptive behavioren.wikipedia.org. So, socially, one tends to be invisible (CDS) and the other too visible (ADHD).There's also an interesting personality distinction noted in research: ADHD is often associated with being reward-seeking and novelty-loving, whereas CDS might come with a higher sensitivity to punishment or a tendency to avoid risksen.wikipedia.org. It's like ADHD is always pressing the gas pedal looking for something fun, and CDS is hovering over the brake, worried about making a wrong move. This could be one reason we see less rule-breaking behavior in CDS – those individuals aren't the ones typically running toward trouble; if anything, they're stuck trying to remember what the next step was.Neuroscience angle (in lay terms): We won't get too technical here, but it's worth noting that scientists suspect the brain mechanisms differ between these two conditions. ADHD is often tied to issues with executive functions and inhibitory control (trouble stopping impulses, difficulty with the brain's “braking system”). CDS seems to be more about a deficit in starting and sustaining cognitive engagement – maybe a lower general arousal or alertness level in the brain. One theory is that different attention networks are involved: ADHD involves circuits that sustain attention and inhibit distractions, whereas CDS might involve circuits that initiate and regulate alertness. From a neurotransmitter perspective, ADHD famously involves dopamine irregularities; with CDS, some researchers wonder if there's a component of the brain's arousal system (possibly a norepinephrine angle, since alertness is at issue) – but the jury's still out. Alright, science hat off now! The key takeaway is that the inattentiveness in CDS qualitatively feels different from the garden-variety ADHD distractibilityen.wikipedia.org.Before we leave this section, it's important to mention: a person can have both ADHD and CDS symptoms together (this is actually pretty common, as we noted earlier). If ADHD is the cake, think of CDS as a flavor of icing that can coat it for some people. Those are the folks who might be especially struggling – for example, they have the hyperactivity or impulsivity of ADHD and the foggy drifting of CDS. On the flip side, there are some who just have one or the other. The overlap has made it a bit tricky in the past for doctors to decide, “Is this a new condition or just part of ADHD?” But recent consensus leans toward CDS being its own construct, not just “ADHD-lite.” In fact, a large meta-analysis of around 19,000 people found that ADHD symptoms and CDS symptoms, while often co-occurring, do factor out as distinct inattention patternsmedvidi.com. So, think of them like two circles in a Venn diagram: they overlap in the middle (many people have both), but each also has an area that doesn't overlap – unique features that the other doesn't share.In summary, ADHD and Cognitive Disengagement Syndrome are like two different flavors of attention deficit. ADHD is the high-speed, impulsive, “lots of oomph but hard to control” flavor, and CDS is the slow, dreamy, “low oomph, hard to get going” flavor. Both can make school, work, and life challenging, but in distinct ways. Understanding these differences isn't just academic – it matters because it affects how someone feels inside, and it can guide different approaches to help them. And speaking of that, why is it that so many people with CDS have been flying under the radar or getting mislabeled? That brings us to our next segment.Why Is CDS Often Misdiagnosed (or Missed Entirely)?Cognitive Disengagement Syndrome has been called an “underrecognized” condition – and for good reason. It's like the introvert at the party of mental health conditions: quiet, not drawing attention to itself, and often misunderstood. Let's unpack why so many people with CDS get misdiagnosed or overlooked, often as having something else like ADHD, depression, or anxiety.One big reason is history and awareness. Until recently, most clinicians and educators didn't have CDS on their radar at all. If a child was struggling to pay attention, the go-to thought would be “this might be ADHD” (or if the child was very quiet and slow, maybe “this kid is depressed or has an anxiety issue”). Sluggish Cognitive Tempo, as a term, has been around for decades in research, but it never made it into the official diagnostic manualsstatnews.com. So unlike ADHD, which every teacher, parent, or doctor has heard of, SCT/CDS has kind of been the forgotten step-sibling of ADHD. A lot of professionals simply weren't taught about it. This means a kid showing these symptoms might get an ADHD-inattentive type diagnosis by default, or if they don't tick enough ADHD boxes, they might just be shrugged off as a “daydreamer” or mischaracterized as having low motivation.Symptom overlap is another culprit. As we discussed, there's a ton of overlap between inattentive ADHD and CDS. That overlapping 30-50% of cases can be confusingen.wikipedia.org. Many clinicians historically would have just said “well, it's basically ADHD” and not bother with a separate label. The downside? If it is CDS, the subtleties (like the constant drowsiness or internal thought-wandering) might not be addressed by standard ADHD strategies or medications. But if no one's distinguishing it, the person might just be lumped under ADHD and left wondering why some typical ADHD advice doesn't quite fit them.Now, consider how CDS presents behaviorally: these individuals usually aren't causing trouble. They're not hyper or defiant; if anything, they're too well-behaved but mentally absent. Teachers love that they're not disruptive, so they might not refer them for evaluation as quickly as the kid who won't stay in his seat. A student with CDS might sit quietly in the back, half-listening, half in La-La Land. They could be struggling massively internally, but because they're not jumping on desks or failing every test, it slides under the radar. They often get comments like “needs to pay more attention” or “so bright, but doesn't apply themselves” on report cards – sound familiar to anyone? Those kinds of comments are classic for undiagnosed attention issues that don't fit the loud ADHD stereotype.Another reason for misdiagnosis is the similarity to depression or anxiety symptoms. Think about it: if someone is consistently sluggish, low-energy, apathetic, and staring off, a clinician might immediately consider depression. In fact, lethargy and concentration problems are key symptoms of depression as well. Anxiety, especially in kids, can sometimes look like zoning out or being “in their head” worrying. So, it's easy to see how a person with CDS might get diagnosed with an anxiety disorder or depression when the core issue is actually this attention disengagement problem (though to complicate matters, the person could also be anxious or depressed – those can co-occur). There's evidence of a strong link between CDS symptoms and internalizing disorders like anxiety/depressioncogepderg.com, which means clinicians really have to tease apart: is the daydreaming because of depression? Or is the depression developing because the person is always struggling and feeling out of sync? It can be a chicken-and-egg situation.Misinterpretation by others adds to the mess. Earlier I mentioned people with CDS might be seen as aloof or unmotivated. Let's double down on that: friends, family, and even doctors can wrongly attribute the behavior to character traits. A child who doesn't respond quickly or seems “out of it” might get labeled as lazy, shy, or even oppositional (when they don't follow instructions, not out of defiance but because their mind wandered off). One heartbreaking example comes from a real story: a teenage girl was so quiet and zoned out in class that teachers literally marked her as absent when she was right there in her seatstatnews.com. Can you imagine? She was physically present but so mentally checked-out due to CDS that she might as well have been invisible. For years she and her parents thought her issues were just from anxiety and depression. It wasn't until she stumbled on the term “sluggish cognitive tempo” in an old psych report that things clickedstatnews.comstatnews.com. Suddenly, the excessive daydreaming, the brain fog – it all made sense as a distinct thing. But it took that long for anyone to connect the dots, because the default assumptions were other diagnoses.There's also a bit of controversy in the professional community that has affected recognition. Some experts have criticized the push to make CDS an official diagnosis, arguing that it might pathologize normal traits or that it's just a fragment of ADHD or other disordersedgefoundation.orgstatnews.com. They worry about overdiagnosis – like, are we going to start labeling every dreamy kid with a disorder? Are pharma companies just looking for the next condition to medicate? These are valid concerns, and it's good that scientists are cautious. However, the flip side is that by not recognizing CDS, people who truly suffer from it might not get the specific help they need. It's a fine line. The consensus that has emerged is that while we're debating the labels, the symptoms are very real and can be seriously impairingedgefoundation.org. So misdiagnosis happens both ways: some get diagnosed with something else incorrectly, and some don't get diagnosed with anything at all – they're just “undiagnosed and unhappy.”Finally, the nature of CDS itself can fool clinicians. Since these folks often have some degree of attention capacity (for example, they might do okay in one-on-one situations or when very interested in a topic), their issue might not scream “attention disorder” in a short doctor's visit. They might not report the hyperactive symptoms (because they have none), so if the practitioner isn't well-versed in SCT, they might not recognize that a pattern of lifelong “dreaminess” is a sign of an attention-related condition. In adults, this is even trickier: an adult who complains of brain fog might get checked for thyroid problems, anemia, sleep apnea, etc., and if all those are negative, the fatigue and fog might be attributed to stress or depression. Rarely does a doctor say, “Hey, could this be that thing called cognitive disengagement syndrome?” – at least not yet, since awareness is still growing.The result of misdiagnosis or missing the diagnosis? People can go years thinking they're just bad at life or “lazy.” They internalize a lot of negative self-talk. A kid might grow up being scolded for daydreaming, a teen might get told “you just need to try harder,” and an adult might wonder why they can't seem to hold onto their thoughts in meetings when everyone else manages fine. It can be frustrating and demoralizing. Some individuals end up on treatments that don't fully help – for instance, they might be given stimulant medication for ADHD and find that, while it might boost focus a bit, it doesn't magically clear the fog like it does for a classic ADHD caseadditudemag.com. Or they might be on antidepressants that help mood but not their spacing-out episodes.The bottom line here is that CDS often flies under the radar. Its sufferers might get diagnosed with something more obvious or nothing at all. The condition is underrecognized in both the medical field and public awareness. That's why one of my goals today (and the reason you're still listening) is to shine a light on it. Because once you do recognize it, you can start doing something about it – which is exactly what we'll talk about next.Up to now, we've painted a pretty challenging picture – brain fog, misdiagnoses, feeling overlooked. But don't worry: this isn't all doom and gloom. In the next segment, we're switching gears to something more empowering: practical tips and strategies. If you or someone you care about is dealing with CDS (or heck, even if you just relate to some of this foggy focus stuff), what can be done? How can you manage these symptoms and make life a bit easier? Let's explore that.Practical Tips for Managing CDSAlright, let's roll up our sleeves and get practical. Cognitive Disengagement Syndrome can make everyday tasks feel like you're swimming upstream, but there are ways to manage it and improve your day-to-day functioning. Whether you're an adult with CDS, a parent or teacher of someone who has it, or just someone listening along for knowledge, these tips will be helpful. We're going to cover a mix of lifestyle habits, strategies, and supports – essentially, how to give that “sluggish” brain a bit of a tune-up or workaround. Think of it as creating an environment where your brain's engine has some extra help turning over. Let's break down some strategies:* Prioritize Sleep and Healthy Habits: This one's not glamorous, but it's huge. Since people with CDS often feel drowsy or low-energy, getting consistent, quality sleep is vital. Poor sleep will only pour molasses on an already sluggish cognitive tempo. Aim for a regular sleep schedule and good sleep hygiene (yes, that means putting down the phone at night and maybe actually going to bed on time, a tough ask, I know!). Also, pay attention to diet and exerciseedgefoundation.org. Physical activity can temporarily boost alertness – even a brisk walk or a few jumping jacks when you're feeling foggy can restart the engine. Eating balanced meals and staying hydrated helps too (blood sugar crashes or dehydration can worsen that spaced-out feeling). Some folks find that a bit of caffeine in moderation helps shake off the cobwebs, but be careful not to overdo it, especially if you also have anxiety. Think of healthy habits as the foundation; they won't eliminate CDS, but they raise your baseline energy and brain health, giving you a fighting chance on those heavy-brain-fog days.* Use External Structures to Stay On Track: If the issue is that your brain disengages internally, one solution is to bring in external engagement. This means using tools and routines to keep you anchored to tasks. For example, timers and alarms can be your best friend. Set a timer for, say, 10 minutes and tell yourself, “I'll work on this task until the timer rings, then I can pause.” Often, just that little auditory cue and the knowledge of a break coming can help you initiate a task. Visual reminders are great too – post-it notes in key places, a big wall calendar, or phone reminders that pop up with messages like “Hey, are you on task?

This week, we talk to two longtime restaurant critics from different parts of the country about what makes their work so interesting and what they're excited to eat. First, Bill Addison, restaurant critic for The Los Angeles Times, talks about his approach to critical writing, his favorite restaurant experiences, and the evolution of California cuisine. He just wrapped up one of the most ambitious projects of his career, the list of the One Hundred and One Best Restaurants in California for The Los Angeles Times. Then, we turn to the Midwest to join Wini Moranville, a restaurant critic based in Des Moines, Iowa. She tells us about her first job as a restaurant server and how that influenced her current work reviewing restaurants, and how restaurant criticism in smaller cities often have very different considerations. Wini is the author of the memoir "Love is My Favorite Flavor: A Midwestern Dining Critic Tells All," and you can check out her Substack, Dining Well in DSM.Broadcast dates for this episode:June 13, 2025 (originally aired)Your support is a special ingredient in helping to make The Splendid Table. Donate today

Send us a textThe Structured Clinical Interview for DSM-5 (SCID-5) stands as a cornerstone in modern mental health assessment, offering clinicians and researchers a sophisticated tool that marries systematic evaluation with clinical flexibility. This semi-structured interview masterfully balances the precision of standardized questioning with the nuance of open-ended exploration, allowing mental health professionals to gather essential diagnostic information while honoring each client's unique lived experience. The approach creates space for clients to describe their symptoms in their own words, ensuring both diagnostic accuracy and therapeutic rapport.Recognizing diverse professional needs, the SCID-5 comes in three specialized formats: the streamlined Clinician Version (SCID-5-CV) for daily practice, the comprehensive Research Version (SCID-5-RV) for academic studies, and the rigorous Clinical Trials Version (SCID-5-CT) for standardized research protocols. The clinician version includes ten meticulously organized diagnostic modules covering 39 common mental health conditions, from major depression and anxiety disorders to substance use problems and ADHD, while screening for 17 additional disorders.The interview process unfolds naturally, beginning with an introductory conversation that establishes rapport while gathering crucial background information. As the assessment progresses, clinicians follow decision trees that mirror expert diagnostic reasoning, systematically evaluating potential diagnoses based on DSM-5 criteria. This methodical approach empowers professionals to make evidence-based diagnostic determinations while remaining responsive to new information that may emerge throughout treatment.Join us as we explore how this remarkable diagnostic tool transforms mental health assessment, creating a bridge between standardized criteria and clinical wisdom that ultimately leads to better outcomes for those seeking care. Subscribe now for more insights into the cutting-edge approaches shaping modern mental healthcare.If you need to study for your national licensing exam, try the free samplers at: LicensureExamsThis podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.

Discover what's possible when different brains come together.  Dr. Temple Grandin is well known for both her pioneer work as an autism advocate and her lifelong dedication to animal welfare. Through groundbreaking research aimed at understanding her own autistic mind, Dr. Grandin propelled the awareness of autism during a time when very little was known of it. She is an incredible source of hope for children with autism, their parents, and anyone with a dream.  Dr. Grandin became an internationally recognized leader in animal handling innovations after developing a corral that improved the quality of life of cattle by reducing stress. She has consulted with the USDA and major corporations such as McDonald's, Wendy's, Burger King, Whole Foods, and Chipotle. Today, half of the cattle in North America are handled in facilities she designed.  Dr. Grandin is also a prominent author, having written several books on autism and animal behavior. She has been featured on various media outlets and programs, including NPR, BBC, Larry King Live, 2020, Sixty Minutes, and TED, to name a few. In 2010, HBO produced an Emmy Award-winning movie about her life, and later that year, she was highlighted in TIME magazine's 100 Most Influential People in the World. In 2016, she was inducted into the American Academy of Arts and Sciences. These days, Dr. Grandin continues to write and teaches Animal Science at Colorado State University.  In this episode, we discuss: The spectrum of autism needs The evolution of diagnostic criteria  Dr. Grandin's opinion on the removal of Asperger's syndrome from the DSM-5 and the classification of autism under a single umbrella The neurodiversity movement ABA therapy Teaching autism awareness in schools Mental health challenges faced by autistic individuals Tips for autistic self-advocates, encouraging targeted advocacy and constructive action to make a difference in their communities For more information about Dr. Grandin and her work, please visit:  https://www.templegrandin.com/   https://www.grandin.com/ ----more---- This conversation with Dr. Temple Grandin was originally released on December 10, 2020.  Dr. Grandin's most recent book Autism and Education: The Way I See It: What Parents and Teachers Need to Know was published in April 2023. ----more---- We appreciate your time. If you enjoy this podcast and you'd like to support our mission, please take just a few seconds to share it with one person who you think will find value in it too. Follow us on Instagram: @autismpodcast Join our community on Mighty Networks: Global Autism Community Subscribe to our YouTube channel: Global Autism Project We would love to hear your feedback about the show. Please fill out this short survey to let us know your thoughts: Listener Survey

Dr. David Kessler is a renowned pediatrician, lawyer, public health advocate, and former Commissioner of the U.S. Food and Drug Administration (FDA). A graduate of Amherst College, the University of Chicago Law School, and Harvard Medical School, Dr. Kessler has spent his career at the intersection of science, policy, and consumer protection. He served as Dean of the Yale School of Medicine and the University of California, San Francisco Medical School, and most recently held the role of Chief Science Officer for the White House COVID-19 Response Team. Dr. Kessler is the acclaimed author of several influential books including the New York Times bestseller The End of Overeating, Fast Carbs, Slow Carbs, and his latest work, Diet, Drugs & Dopamine: The New Science on Achieving a Healthy Weight. His writing and research have been pivotal in shifting the public health conversation from willpower to biological understanding—especially regarding food addiction, the manipulation of hyper-palatable foods, and the role of dopamine in modern eating behaviors. A true trailblazer in the field, Dr. Kessler has dedicated decades to unraveling the powerful science behind why we eat the way we do—and how we can reclaim our health in a world of ultra-processed foods. Dr. Kessler shares his personal journey with weight regain and the "aha moment" that led him to call it what it is—addiction. He explores the role of GLP-1 medications, the dark side of food addiction, and how we must move beyond willpower to tackle this epidemic with compassion, science, and actionable tools.

Dr. John Kruse is a neuroscientist, psychiatrist, and author with 25 years of experience specializing in adult ADHD. He earned his MD and PhD in Neuroscience from the University of Rochester. Dr. Kruse is known for his book, "Recognizing Adult ADHD: What Donald Trump Can Teach Us About Attention Deficit Hyperactivity Disorder," and focuses on helping patients understand and manage ADHD through various therapeutic approaches.In our conversation we discuss:(00:00) - Defining ADHD and DSM criteria(01:44) - How adult ADHD is diagnosed(03:36) - ADHD vs. other mental conditions(06:10) - Executive function and brain chemistry(08:32) - Biological markers and group overlap(11:38) - ADHD diagnosis trends and underdiagnosis(15:18) - ADHD increase during COVID explained(18:06) - Why adult ADHD went unrecognized(21:24) - Misdiagnosis and long-term consequences(27:17) - Genetics and shared mental health traits(31:01) - Trauma vs. genetic origins of ADHD(39:02) - Life impacts of untreated ADHD(46:19) - Interest-driven attention and hyperfocus(50:05) - ADHD strengths in entrepreneurship(01:11:38) - First steps and treatment optionsLearn more about Dr. John Kruse:YouTube Channel: youtube.com/9Reddit Subreddit: reddit.com/r/DrJohnKruse/Medium Articles: https://www.google.com/search?q=dockruse.medium.comWatch full episodes on: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/@seankim⁠⁠⁠⁠⁠⁠⁠Connect on IG: ⁠⁠⁠⁠⁠⁠https://instagram.com/heyseankim

Send us a textThis week were talking about ADHD and the sysmtoms of inattention. It's easy to glance at the DSM checklist and think, “That's not me.” But when you really look at how these symptoms show up in everyday life? Suddenly it's very relatable.We're breaking down inattentive ADHD in a way that actually makes sense with real-life examples and a few funny (okay, slightly chaotic) relatiable stories of how it shows up for us. Join us for some fun and laughter!Support the showIf you'd like to support the show please consider subscribing to us, it starts at $3 a month:BUZZSPROUT Subscriptionhttps://www.buzzsprout.com/1898728/supporters/newBuy Me A Coffeehttps://bmc.link/adopaminekickThanks so much to anyone that donates to us, we really appreciate it.Our Socialswww.adopaminekick.comFollow us on Instagramwww.instagram.com/adopaminekickLike us on Facebookwww.facebook.com/adopaminekickEmail us: adopaminekick@gmail.com Support the show

Link for CME credit : https://cmetracker.net/UTHSCSA/Publisher?page=pubOpen#/getCertificate/10098850 In this enlightening episode, a talk by: Avinash Boddapati, M.D.  Child and Adolescent Psychiatrist | Assistant Professor of Psychiatry  we dive into the intricacies of Autism Spectrum Disorder (ASD) according to the DSM-5, offering clarity on diagnostic criteria and differentiating ASD from other neurodevelopmental and social communication disorders. We explore the prevalence of ASD, its genetic and environmental risk factors, and dispel common myths, such as the debunked link between vaccines and autism. Discover the unique challenges individuals with ASD face in social communication, restrictive behaviors, and sensory sensitivities, accompanied by an examination of common comorbidities. The episode further addresses the significance of early diagnosis and intervention, discussing various screening tools and the benefits of catching ASD early on. We also outline an array of therapeutic approaches—from behavioral therapies like Applied Behavior Analysis (ABA) to pharmacological interventions for managing symptoms. Plus, engage with real-life case studies to illustrate ASD's diverse manifestations and the potential for tailored interventions. Join us as we untangle the complexities of ASD, fostering a better understanding of the spectrum and encouraging effective support strategies for individuals and their families.

An episode that took a fantasy and made it reality.In Episode 139 of The Autistic Culture Podcast, Dr Angela Kingdon continues our journey through the 10 Pillars of Autistic Culture with Dr. Scott Frasard, as we move onto Pillar 4 — World building. Dr. Scott Frasard is an autistic autism advocate who is a published author and an outspoken critic of operant conditioning approaches to change natural autistic behaviors to meet neuro-normative social expectations.Dr Scott Frasard decided he wasn't going to critique the status quo, he was going to build something new. His essay, ‘The World We Built: A Future Where Autistic People Are Respected, Not Repaired,' set in 2075, imagines a world where autism is no longer pathologized. Where the DSM is behind museum glass, and identity is co-created, not diagnosed.You can read it in full here.Here's what defines this core Autistic trait:*

Licensed clinical psychologist and health care ethicist Jenny Shields discusses her article, "DSM-5 doesn't name it, but moral distress is everywhere in medicine." Jenny illuminates the pervasive issue of moral distress among clinicians, defining it as the psychological toll exacted when they know the ethically appropriate action but are systematically prevented from taking it by institutional constraints such as hospital policies or insurer mandates. She carefully distinguishes moral distress from burnout or trauma, characterizing it as a chronic erosion of professional identity that occurs when daily work consistently conflicts with the core values that drew clinicians to their profession. Examples cited include understaffing in the face of rising executive compensation and adherence to insurer-driven care plans over sound medical judgment. Jenny describes the accumulation of "moral residue"—a lasting emotional injury—and a form of institutional gaslighting where systemic issues are presented as improvements, causing clinicians to doubt their own perceptions. She argues that by not naming moral distress, diagnostic manuals like the DSM-5 contribute to medicalizing symptoms like burnout, thereby avoiding the underlying ethical fractures in a health care system primarily designed around revenue and efficiency, which consistently deprioritizes ethics. The article calls for a shift away from focusing on individual clinician resilience towards demanding fundamental systemic changes to address this profound ethical crisis. Our presenting sponsor is Microsoft Dragon Copilot. Want to streamline your clinical documentation and take advantage of customizations that put you in control? What about the ability to surface information right at the point of care or automate tasks with just a click? Now, you can. Microsoft Dragon Copilot, your AI assistant for clinical workflow, is transforming how clinicians work. Offering an extensible AI workspace and a single, integrated platform, Dragon Copilot can help you unlock new levels of efficiency. Plus, it's backed by a proven track record and decades of clinical expertise and it's part of Microsoft Cloud for Healthcare–and it's built on a foundation of trust. Ease your administrative burdens and stay focused on what matters most with Dragon Copilot, your AI assistant for clinical workflow. VISIT SPONSOR → https://aka.ms/kevinmd SUBSCRIBE TO THE PODCAST → https://www.kevinmd.com/podcast RECOMMENDED BY KEVINMD → https://www.kevinmd.com/recommended

Podcast sponsors:1) Trinergy Health offers a 6-month program for mind-body recovery and wellness. Based on the foundational framework of Diet/trauma/toxins. To schedule an intake appointment, go to https://psychiatry2.com/schedule/ or call 262-955-6601. Use code Rav10 to get 10% discount for holistic psychiatry program.2) Alcami Elements - a natural, adaptogenic herbal supplement to kickstart your day! https://www.alcamielements.com/ Receive 10% OFF first order or 30% OFF subscription order using code: ILLUSIONIn this episode, Rav is joined by journalist and author Mia Hughes (The WPATH Files) for a wide-ranging conversation on the rise of gender dysphoria, particularly among adolescent girls. They explore the psychological and cultural forces driving this trend, including trauma, social contagion, and the influence of online communities. Mia shares her personal journey and offers a critical perspective on gender-affirming care, the phenomenon of autogynephilia, and the concept of diagnostic overshadowing—where gender identity becomes the sole focus of treatment at the expense of underlying mental health conditions. Together, they reflect on the ethical dilemmas within the trans rights movement, the medicalization of nonconforming identity, and the growing cultural shift toward victimhood over resilience.Chapters:00:00 Introduction to Gender Affirming Care02:02 Mia Hughes' Journey and Background05:20 The WPATH Files and Medical Scandal07:49 Statistics and Social Contagion in Gender Dysphoria12:55 Counterarguments: Transgender Identification vs. Homosexuality15:45 The Nature of Gender Dysphoria21:16 Understanding Autogynephilia27:26 The Impact of Trans Rights Movement33:01 Comparing Autogynephilia and Homosexuality40:23 Understanding Autogynephilia and Its Implications44:04 The Debate on Gender-Affirming Care50:29 Demographics of Gender Dysphoria58:49 The Role of Trauma in Gender Dysphoria01:12:32 Causation vs Correlation in Gender Identity01:14:58 Understanding Mental Health: Symptoms vs. Explanations01:18:47 The Role of Trauma in Mental Health01:21:35 The DSM and the Nature of Psychiatric Diagnoses01:24:29 The Impact of Labels on Mental Health01:27:48 Mindfulness and Mental Health01:32:23 The Utility of Diagnoses in Self-Discovery01:36:34 Navigating ADHD and Attention Issues01:42:11 The Paradox of Modern Life and Mental Health01:45:53 Victimhood Culture and Mental Health Perspectives This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.illusionconsensus.com/subscribe

Um interessierten Familien bei der Schulauswahl zu helfen, hat die Deutsche Schule Melbourne (DSM) am letzten Wochenende ihre Türen geöffnet und durch Frage-Antwort-Runden, Aktivitäten, Schultouren und mehr ihr bilinguales Schulangebot vorgestellt. Wir haben mit Lehrerinnen und Lehrern, Schulpädagogen und dem Direktor gesprochen und gefragt, für wen das Programm der DSM geeignet ist.

Are you labeling someone a narcissist... when they might actually be a falsely empowered codependent?In this episode of the Heal the Hurt Podcast, we dive deep into one of the most common—and most dangerous—misunderstandings in emotional healing and relationship dynamics. Many people confuse certain types of codependency with narcissism, and that confusion can destroy relationships that are actually salvageable.Kenny Weiss explains:

Bill Bender talks College Football, Maury Hanks on the Iowa basketball game in DSM & Trent's Picks presented by Circa Sports

Bill Bender talks College Football, Maury Hanks on the Iowa basketball game in DSM & Trent's Picks presented by Circa Sports

Aujourd'hui, nous allons parler d'un mal discret, difficile à nommer, mais qui touche de plus en plus de personnes : le syndrome de la vie vide.Ce n'est pas une maladie officiellement reconnue. Vous ne la trouverez pas dans les manuels de psychiatrie comme le DSM-5. Et pourtant, elle est bien réelle. Le syndrome de la vie vide, c'est ce sentiment diffus de vide intérieur, d'ennui existentiel, de perte de sens. Comme si on vivait en pilote automatique, sans élan, sans envie, sans but.Et les chiffres parlent d'eux-mêmes. En France, 22 % des adultes déclarent ressentir régulièrement un manque de sens dans leur vie, selon un rapport de Santé Publique France. Et ce chiffre grimpe à 36 % chez les 18-35 ans, preuve que cette sensation de vide touche aussi – et peut-être surtout – les jeunes générations.Mais attention : ce n'est pas nécessairement de la tristesse, ni une vraie dépression. C'est plus subtil. Vous vous levez le matin, vous faites ce que vous avez à faire… mais vous n'en retirez aucune satisfaction. Vous avez l'impression que tout est creux, mécanique, que rien ne vous touche vraiment. Et surtout, vous ne savez pas toujours pourquoi.Ce syndrome peut apparaître dans des vies qui, de l'extérieur, semblent réussies. Une bonne situation, une famille, une stabilité… et pourtant, un désert intérieur. Il peut aussi émerger après une étape marquante : la retraite, une séparation, le départ des enfants… ou même l'atteinte d'un objectif longtemps poursuivi. Et une fois ce but atteint ? Le vide. Parce qu'en fait, on ne savait plus ce qu'on voulait vraiment.À l'échelle mondiale, l'Organisation mondiale de la santé estime que 5 % des adultes souffrent de dépression. Même si le syndrome de la vie vide n'est pas une dépression, il peut en être le terrain favorable, quand il persiste sans être reconnu.Souvent, ce malaise vient d'un décalage entre nos actions quotidiennes… et ce qui a vraiment du sens pour nous. Une vie remplie de tâches, mais pas de passion. De bruit, mais pas d'écoute de soi.Alors, comment faire ?Commencer par nommer ce vide. Puis, interroger son quotidien : qu'est-ce qui me touche ? me nourrit ? me fait vibrer ? Redonner du sens, non pas en faisant plus… mais en vivant mieux.Ce vide, parfois silencieux, peut être un début. Le début d'un recentrage, d'une reconstruction, d'un vrai choix de vie. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Episode 192: ADHD Treatment.  Jordan Redden (MSIV) explains the treatment of ADHD. Dr. Bustamante adds input about pharmacologic and non-pharmacologic treatments. Dr. Arreaza shares the how stimulants were discovered as the treatment for ADHD. Written by Jordan Redden, MSIV, Ross University School of Medicine. Comments and edits by Isabelo Bustamante, MD, and Hector Arreaza, MD. You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Introduction.ADHD is a chronic neurodevelopmental condition characterized by inattention, impulsivity, and/or hyperactivity. While it's often diagnosed in childhood, symptoms can persist well in adulthood. The treatment for ADHD is multifaceted. It often includes medication, behavioral therapy, environmental modifications, and sometimes educational interventions which are especially effective in younger patients. Ongoing evaluation is needed during treatment. Treatment needs adjustments over time.Starting with medications: Stimulants are the most well-studied and effective pharmacologic treatment for ADHD. These include methylphenidate-based medications such as Ritalin, Concerta, and Focalin, and amphetamine-based options, like Adderall, Vyvanse, and Dexedrine. Discovery of stimulants for ADHD> Dr. Charles Bradley discovered stimulants as the treatment for ADHD around 1937. ADHD did not have a name at that time, but it was known that some children had behavioral problems related to poor attention and inability to control their impulses, but they were still intelligent. Dr. Bradley was a psychiatrist who was working in the Bradley Hospital (Rhode Island), he was studying these children and, as part of his experiments, they developed severe headaches. He gave “Benzedrine” (a decongestant) to his pediatric patients to treat severe headaches, and he discovered that Benzedrine improved academic performance and interest in school and improved disruptive behavior in some children.How do stimulants work.Stimulants work primarily by increasing dopamine and norepinephrine levels in the brain, which helps improve focus, attention span, and impulse control. They typically show a rapid onset of action and can lead to noticeable improvements within the first few days of use. Dosing is individualized and should start low with gradual titration. Side effects can include reduced appetite, insomnia, headaches, increased heart rate, and emotional lability.Types of stimulants. Stimulants come as short acting and long acting. They can come as a tablet, liquid, patch, or orally disintegrating tablet. After the discovery of Benzedrine as a possible treatment for ADHD, more research was done over the years, and Ritalin became the first FDA-approved medication for ADHD (1955). The list of medications may seem overwhelming, but there are only two types of stimulants used to treat ADHD: methylphenidate and amphetamine. Long-acting stimulant medications are often preferred for their consistent symptom control and lower potential for misuse. Vyvanse (lis-dexa-mfetamine) is a widely used long-acting amphetamine-based option. As a prodrug, it remains inactive until metabolized in the body, which results in a smoother onset and offset of action and may reduce the risk of abuse. This extended duration of effect can help patients maintain focus and regulate impulses throughout the day without the peaks and crashes sometimes seen with shorter-acting formulations. Of note, Vyvanse is also approved for Binge Eating Disorder. Many of these medications are Schedule II controlled substances, so to prescribe them you need a DEA license. Other long-acting options include Concerta, an extended-release methylphenidate, as well as extended-release versions of Adderall and Focalin. These are especially helpful for school-aged children who benefit from once-daily dosing, and for adults who need sustained attention during work or academic activities. The choice between short- and long-acting stimulants depends on individual response, side effect tolerance, and daily routine.For patients who cannot tolerate stimulants, or for those with contraindications such as a history of substance misuse or certain cardiac conditions, non-stimulant medications are an alternative. One of the most used is atomoxetine, which inhibits the presynaptic norepinephrine transporter (NET). This leads to increased levels of norepinephrine (and to a lesser extent dopamine). Guanfacine or clonidine are alpha-2A adrenergic receptor agonists that lead to reduced sympathetic outflow and enhanced prefrontal cortical function, improving attention and impulse control. These alpha agonists are particularly useful in younger children with significant hyperactivity or sleep disturbances.Non-pharmacologic treatments.Behavioral therapy before age 6 is the first choice, after that, medications are more effective than BH only, and as adults again you use CBT.Medication is often just one part of a broader treatment plan. Behavioral therapy, especially in children, plays a critical role. Parent-training programs, positive reinforcement systems, and structured routines can significantly improve functioning. And for adolescents and adults, cognitive-behavioral therapy (CBT) is particularly helpful. CBT can address issues like procrastination, time management, emotional regulation, and self-esteem which are areas that medication doesn't always touch.Using medications for ADHD can be faced with resistance by parents, and even children. There is stigma and misconceptions about mental health, there may be concerns about side effects, fear of addiction, negative past experiences, and some parents prefer to treat ADHD the “natural” way without medications or only with supplements. All those concerns are valid. Starting a medication for ADHD is the first line of treatment in children who are 6 years and older, but it requires a shared decision with parents and patients. Cardiac side effects are possible with stimulants. EKG may be needed before starting stimulants, but it is not required. Get a personal and family cardiac history, including a solid ROS. Benefits include control of current condition and treating comorbid conditions.The presentation of ADHD changes as the person goes through different stages of life. For example, you may have severe hyperactivity in your school years, but that hyperactivity improves during adolescence and impulsivity worsens. It varies among sexes too. Women tend to present as inattentive, and men tend to be more hyperactive. ADHD is often underdiagnosed in adults, yet it can significantly impact job performance, relationships, and mental health. In adults, we often use long-acting stimulants to minimize the potential for misuse. And psychotherapy, particularly CBT or executive functioning coaching, can be life-changing when combined with pharmacologic treatment. There are several populations where treatment must be tailored carefully such as pregnant patients, individuals with co-occurring anxiety or depression, and those with a history of substance use. For example, atomoxetine may be preferred in patients with a history of substance misuse. And in children with coexisting oppositional defiant disorder, combined behavioral and pharmacologic therapy is usually more effective than either approach alone.Comorbid conditions.Depression and anxiety can be comorbid, and they can also mimic ADHD. Consult your DSM-5 to clarify what you are treating, ADHD vs depression/anxiety.Treatment goes beyond the clinic. For school-aged children, we often work closely with schools to implement 504 plans or Individualized Education Programs (IEPs) that provide classroom accommodations. Adults may also benefit from workplace strategies like structured schedules, noise-reducing headphones, or even coaching support. Ongoing monitoring is absolutely essential. We assess side effects of medication, adherence, and symptom control. ***In children, we also monitor growth and sleep patterns. We often use validated rating scales, like the Vanderbilt questionnaire for children 6–12 (collect answers from two settings) or Conners questionnaires (collect from clinician, parents and teachers), to track progress. And shared decision-making with patients and families is key throughout the treatment process.To summarize, ADHD is a chronic but manageable condition. Effective treatment usually involves a combination of medication and behavioral interventions, tailored to the individual's needs. And early diagnosis and treatment can significantly improve quality of life academically, socially, and emotionally.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed., text rev. (DSM-5-TR). Washington, DC: American Psychiatric Association; 2022. CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder). Understanding ADHD. Accessed May 2025. https://chadd.org National Institute for Health and Care Excellence (NICE). Attention Deficit Hyperactivity Disorder: Diagnosis and Management. NICE guideline [NG87]. Updated March 2018. Accessed May 2025. https://www.nice.org.uk/guidance/ng87 Pliszka SR; AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry. 2007;46(7):894–921. doi:10.1097/chi.0b013e318054e724 Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528. doi:10.1542/peds.2019-2528 Texas Children's Hospital. ADHD Provider Toolkit. Baylor College of Medicine. Accessed May 2025. https://www.bcm.edu Wolraich ML, Hagan JF Jr, Allan C, et al. Attention deficit hyperactivity disorder in children and adolescents: Overview of treatment and prognosis. UpToDate. Published 2024. Accessed May 2025.https://www.uptodate.comThe History of ADHD and Its Treatments, https://www.additudemag.com/history-of-adhd/Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/. 

Haliburton was Perfect, Chris Connelly on Iowa BB Coming to DSM, Rob Donaldson's Baseball Bets, and more! W H1

In this episode of In-Ear Insights, the Trust Insights podcast, Katie and Chris discuss the critical considerations when deciding whether to hire an external AI expert or develop internal AI capabilities. You’ll learn why it is essential to first define your organization’s specific AI needs and goals before seeking any AI expertise. You’ll discover the diverse skill sets that comprise true AI expertise, beyond just technology, and how to effectively vet potential candidates. You’ll understand how AI can magnify existing organizational challenges and why foundational strategy must precede any AI solution. You’ll gain insight into how to strategically approach AI implementation to avoid costly mistakes and ensure long-term success for your organization. Watch now to learn how to make the right choice for your organization’s AI future. Watch the video here: Can’t see anything? Watch it on YouTube here. Listen to the audio here: https://traffic.libsyn.com/inearinsights/tipodcast-should-you-hire-ai-expert.mp3 Download the MP3 audio here. Need help with your company’s data and analytics? Let us know! Join our free Slack group for marketers interested in analytics! [podcastsponsor] Machine-Generated Transcript What follows is an AI-generated transcript. The transcript may contain errors and is not a substitute for listening to the episode. Christopher S. Penn – 00:00 In this week’s In-Ear Insights, a few people have asked us the question, should I hire an AI expert—a person, an AI expert on my team—or should I try to grow AI expertise, someone as an AI leader within my company? I can see there being pros and cons to both, but, Katie, you are the people expert. You are the organizational behavior expert. I know the answer is it depends. But at first blush, when someone comes to you and says, hey, should I be hiring an AI expert, somebody who can help shepherd my organization through the crazy mazes of AI, or should I grow my own experts? What is your take on that question? Katie Robbert – 00:47 Well, it definitely comes down to it depends. It depends on what you mean by an AI expert. So, what is it about AI that they are an expert in? Are you looking for someone who is staying up to date on all of the changes in AI? Are you looking for someone who can actually develop with AI tools? Or are you looking for someone to guide your team through the process of integrating AI tools? Or are you looking for all of the above? Which is a totally reasonable response, but that doesn’t mean you’ll get one person who can do all three. So, I think first and foremost, it comes down to what is your goal? And by that I mean, what is the AI expertise that your team is lacking? Katie Robbert – 01:41 Or what is the purpose of introducing AI into your organization? So, unsurprisingly, starting with the 5P framework, the 5Ps are purpose, people, process, platform, performance, because marketers like alliteration. So, purpose. You want to define clearly what AI means to the company, so not your ‘what I did over summer vacation’ essay, but what AI means to me. What do you want to do with AI? Why are you bringing AI in? Is it because I want to keep up with my competitors? Bad answer. Is it because you want to find efficiencies? Okay, that’s a little bit better. But if you’re finding efficiencies, first you need to know what’s not working. So before you jump into getting an AI expert, you probably need someone who’s a process expert or an expert in the technologies that you feel like are inefficient. Katie Robbert – 02:39 So my personal stance is that there’s a lot of foundational work to do before you figure out if you can have an AI expert. An AI expert is like bringing in an AI piece of software. It’s one more thing in your tech stack. This is one more person in your organization fighting to be heard. What are your thoughts, Chris? Christopher S. Penn – 03:02 AI expert is kind of like saying, I want to hire a business expert. It’s a very umbrella term. Okay, are your finances bad? Is your hiring bad? Is your sales process bad? To your point, being very specific about your purpose and the performance—which are the bookends of the 5Ps—is really important because otherwise AI is a big area. You have regression, you have classification, you have generative AI. Even within generative AI, you have coding, media generation. There’s so many things. We were having a discussion internally in our own organization this morning about some ideas about internationalization using AI. It’s a big planet. Katie Robbert – 03:46 Yeah, you’ve got to give me some direction. What does that mean? I think you and I, Chris, are aligned. If you’re saying, ‘I want to bring in an AI expert,’ you don’t actually know what you’re looking for because there are so many different facets of expertise within the AI umbrella that you want to be really specific about what that actually means and how you’re going to measure their performance. So if you’re looking for someone to help you make things more efficient, that’s not necessarily an AI expert. If you’re concerned that your team is not on board, that’s not an AI expert. If you are thinking that you’re not getting the most out of the platforms that you’re using, that’s not an AI expert. Those are very different skill sets. Katie Robbert – 04:38 An AI expert, if we’re talking—let’s just say we could come up with a definition of an AI expert—Chris, you are someone who I would consider an AI expert, and I would list those qualifications as: someone who stays up to date. Someone who knows enough that you can put pretty much any model in front of them and they know how to build a prompt, and someone who can speak to how these tools would integrate into your existing tech stack. My guess is that’s the kind of person that everybody’s looking for: someone to bring AI into my organization, do some light education, and give us a tool to play with. Christopher S. Penn – 05:20 We often talk about things like strategy, tactics, execution, and measurement. So, sort of four layers: why are you doing this thing? What are you going to do? How are you going to do it, and did it work? An actual AI expert has to be able to do all four of those things to say, here’s why we’re doing this thing—AI or not. But here’s why you’d use AI, here’s what AI tools and technologies you use, here’s how you do them, and here’s the proof that what you did worked. So when someone says, ‘I want an AI expert for my company,’ even then, they have to be clear: do we want someone who’s going to help us set our strategy or do we want someone who’s going to build stuff and make stuff for us? It’s very unclear. Christopher S. Penn – 06:03 I think that narrowing down the focus, even if you do narrow down the focus, you still have to restart the 5Ps. So let’s say we got this question from another colleague of ours: ‘I want to do AI lead generation.’ Was the remit to help me segment and use AI to do better lead generation? Well, that’s not an AI problem. As you always say, new technology does not solve all problems. This is not an AI problem; this is a lead generation problem. So the purpose is pretty clear. You want more leads, but it’s not a platform issue with AI. It is actually a people problem. How are people buying in the age of AI? And that’s what you need to solve. Christopher S. Penn – 06:45 And from there you can then go through the 5Ps and user stories and things to say, ‘yeah, this is not an AI expert problem. This is an attention problem.’ You are no longer getting awareness because AI has eaten it. How are you going to get attention to generate audience that becomes prospects that eventually becomes leads? Katie Robbert – 07:05 Yeah, that to me is an ideal customer profile, sales playbook, marketing planning and measurement problem. And sure, you can use AI tools to help with all of those things, but those are not the core problems you’re trying to solve. You don’t need AI to solve any of those problems. You can do it all without it. It might take a little longer or it might not. It really depends. I think that’s—So, Chris, I guess we’re not saying, ‘no, you can’t bring in an AI expert.’ We’re saying there’s a lot of different flavors of AI expertise. And especially now where AI is the topic, the thing—it was NFTs and it was crypto and it was Bitcoin and it was Web three, whatever the heck that was. And it was, pick a thing—Clubhouse. Katie Robbert – 07:57 All of a sudden, everybody was an expert. Right now everybody’s a freaking expert in AI. You can’t sneeze and not have someone be like, ‘I’m an AI expert. I can fix that problem for you.’ Cool. I’ve literally never seen you in the space, but congratulations, you’re an AI expert. The point I’m making here is that if you are not hyper specific about the kind of expertise you’re looking for, you are likely going to end up with a dud. You are likely going to end up with someone who is willing to come in at a lower price just to get their foot in the door. Christopher S. Penn – 08:40 Yep. Katie Robbert – 08:40 Or charge you a lot of money. You won’t know that it’s not working until it doesn’t work and they’ve already moved on. We talked about this on the livestream yesterday about people who come in as AI experts to fix your sales process or something like that. And you don’t know it’s not working until you’ve spent a lot of money on this expert, but you’re not bringing in any more revenue. But by then they’re gone. They’re already down the street selling their snake oil to the next guy. Christopher S. Penn – 09:07 Exactly. Now, to the question of should you grow your own? That’s a big question because again, what level of expertise are you looking for? Strategy, tactics, or execution? Do you want someone who can build? Do you want someone who can choose tools and tactics? Do you want someone who can set the strategy? And then within your organization, who are those people? And this is very much a people issue, which is: do they have the aptitudes to do that? I don’t mean AI aptitude; I mean, are they a curious person? Do they learn quickly? Do they learn well outside their domain? Because a lot of people can learn in their domain with what’s familiar to them. But a whole bunch of other people are really uncomfortable learning something outside their domain. Christopher S. Penn – 09:53 And for one reason or another, they may not be suited as humans to become that internal AI champion. Katie Robbert – 10:02 I would add to that not only the curiosity, but also the communication, because it’s one thing to be able to learn it, but then you have to, if you’re part of a larger team, explain what you learned, explain why you think this is a good idea. You don’t have to be a professional speaker, be able to give a TED talk, but you need to be able to say, ‘hey, Chris, I found this tool. Here’s what it does, here’s why I think we should use it,’ and be able to do that in a way that Chris is like, ‘oh, yeah! That is a really good idea. Let’s go ahead and explore it.’ But if you just say, ‘I found this thing,’ okay, and congratulations, here’s your sticker, that’s not helpful. Katie Robbert – 10:44 So communication, the people part of it, is essential. Right now, a lot of companies—we talked about this on last week’s podcast—a lot of leaders, a lot of CEOs, are disregarding the people in favor of ‘AI is going to do it,’ ‘technology is going to take it over,’ and that’s just not how that’s going to work. You can go ahead and alienate all of your people, but then you don’t have anyone to actually do the work. Because AI doesn’t just set itself up; it doesn’t just run itself without you telling it what it is you need it to do. And you need people to do that. Christopher S. Penn – 11:27 Yep. Really important AI models—we just had a raft of new announcements. So the new version of Gemini 2.5, the new version of OpenAI’s Codex, Claude 4 from Anthropic just came out. These models have gotten insanely smart, which, as Ethan Mollock from Wharton says, is a problem, because the smarter AI gets, the smarter its mistakes get and the harder it is for non-experts to pick up that expert AI is making expert-level mistakes that can still steer the ship in the wrong direction, but you no longer know if you’re not a domain expert in that area. So part of ‘do we grow an AI expert internally’ is: does this person that we’re thinking of have the ability to become an AI expert but also have domain expertise in our business to know when the AI is wrong? Katie Robbert – 12:26 At the end of the day, it’s software development. So if you understand the software development lifecycle, or even if you don’t, here’s a very basic example. Software engineers, developers, who don’t have a QA process, yes, they can get you from point A to point B, but it may be breaking things in the background. It might be, if their code is touching other things, something else that you rely on may have been broken. But listen, that thing you asked for—it’s right here. They did it. Or it may be using a lot of API tokens or server space or memory, whatever it is. Katie Robbert – 13:06 So if you don’t also have a QA process to find out if that software is working as expected, then yes, they got you from point A to point B, but there are all of these other things in the background that aren’t working. So, Chris, to your point about ‘as AI gets smarter, the mistakes get smarter’—unless you’re building people and process into these AI technologies, you’re not going to know until you get slapped with that thousand-dollar bill for all those tokens that you used. But hey, great! Three of your prospects now have really solid lead scores. Cool. Christopher S. Penn – 13:44 So I think we’re sort of triangulating on what the skills are that you should be looking for, which is someone who’s a good critical thinker, someone who’s an amazing communicator who can explain things, someone who is phenomenal at doing requirements gathering and being able to say, ‘this is what the thing is.’ Someone who is good at QA to be able to say the output of this thing—human or machine—is not good, and here’s why, and here’s what we should do to fix it. Someone who has domain expertise in your business and can explain, ‘okay, this is how AI does or does not fit into these things.’ And then someone who knows the technology—strategy, tactics, and execution. Why are we using this technology? What does the technology do? How do we deploy it? Christopher S. Penn – 14:30 For example, Mistral, the French company, just came up with a new model Dev Stroll, which is apparently doing very well on software benchmarks. Knowing that it exists is important. But then that AI expert who has to have all those other areas of expertise also has to know why you would use this, what you would use it for, and how you would use it. So I almost feel that’s a lot to cram into one human being. Katie Robbert – 14:56 It’s funny, I was just gonna say I feel that’s where—and obviously dating ourselves—that’s where things, the example of Voltron, where five mini-lion bots come together to make one giant lion bot, is an appropriate example because no one person—I don’t care who they are—no one person is going to be all of those things for you. But congratulations: together Chris and I are. That Voltron machine—just a quick plug. Because it’s funny, as you’re going through, I’m like, ‘you’re describing the things that we pride ourselves on, Chris,’ but neither of us alone make up that person. But together we do cover the majority. I would say 95% of those things that you just listed we can cover, we can tackle, but we have to do it together. Katie Robbert – 15:47 Because being an expert in the people side of things doesn’t always coincide with being an expert in the technology side of things. You tend to get one or the other. Christopher S. Penn – 15:59 Exactly. And in our case as an agency, the client provides the domain expertise to say, ‘hey, here’s what our business is.’ We can look at it and go, ‘okay, now I understand your business and I can apply AI technology and AI processes and things to it.’ But yeah, we were having that discussion not too long ago about, should we claim that AI expertise in healthcare technologies? Well, we know AI really well. Do we know healthcare—DSM codes—really well? Not really, no. So could we adapt and learn fast? Yes. But are we practitioners day to day working in an ER? No. Katie Robbert – 16:43 So in that case, our best bet is to bring on a healthcare domain expert to work alongside both of us, which adds another person to the conversation. But that’s what that starts to look like. If you say, ‘I want an AI expert in healthcare,’ you’re likely talking about a few different people. Someone who knows healthcare, someone who knows the organizational behavior side of things, and someone who knows the technology side of things. And together that gives your quote-unquote AI expert. Christopher S. Penn – 17:13 So one of the red flags for the AI expert side of things, if you’re looking to bring in someone externally, is someone who claims that with AI, they can know everything because the machines, even with great research tools, will still make mistakes. And just because someone’s an AI expert does not mean they have the sense to understand the subtle mistakes that were made. Not too long ago, we were using some of the deep research tools to pull together potential sponsors for our podcast, using it as a sales prospecting tool. And we were looking at it, looking at who we know to be in the market: ‘yeah, some of these are not good fits.’ Even though it’s plausible, it’s still not a good fit. Christopher S. Penn – 18:01 One of them was the Athletic Greens company, which, yes, for a podcast, they advertise on every podcast in the world. I know from listening to other shows and listening to actual experts that there’s some issues with that particular sponsorship. So it’s not a good fit. Even though the machine said, ‘yeah, this is because they advertise on every other podcast, they’re clearly just wanting to hand out money to podcasters.’ I have the domain expertise in our show to know, ‘yeah, that’s not a good fit.’ But as someone who is an AI expert who claimed that they understood everything because AI understands everything, doesn’t know that the machine’s wrong. So as you’re thinking about, should I bring an AI expert on externally, vet them on the level, vet them on how willing they are to say, ‘I don’t know.’ Katie Robbert – 18:58 But that’s true of really any job interview. Christopher S. Penn – 19:01 Yes. Katie Robbert – 19:02 Again, new tech doesn’t solve old problems, and AI is, at least from my perspective, exacerbating existing problems. So suddenly you’re an expert in everything. Suddenly it’s okay to be a bad manager because ‘AI is going to do it.’ Suddenly the machines are all. And that’s not an AI thing. Those are existing problems within your organization that AI is just going to magnify. So go ahead and hire that quote-unquote AI expert who on their LinkedIn profile says they have 20 years of generative AI expertise. Good luck with that person, because that’s actually not a thing now. Christopher S. Penn – 19:48 At most it would have to be 8 years and you would have to have credentials from Google DeepMind, because that’s where it was invented. You cannot say it’s anything older than that. Katie Robbert – 20:00 But I think that’s also a really good screening question is: do you know what Google DeepMind is? And do you know how long it’s been around? Christopher S. Penn – 20:09 Yep. If someone is an actual AI expert—not ‘AI and marketing,’ but an actual AI expert itself—can you explain the Transformers architecture? Can you explain the diffuser architecture? Can you explain how they’re different? Can you explain how one becomes the other? Because that was a big thing that was announced this week by Google DeepMind. No surprise about how they’re crossing over into each other, which is a topic for another time. But to your point, I feel AI is making Dunning-Kruger much worse. At the risk of being insensitive, it’s very much along gender lines. There are a bunch of dudes who are now making wild claims: ‘no, you really don’t know what you’re talking about.’ Katie Robbert – 21:18 I hadn’t planned on putting on my ranty pants today, but no, I feel that’s. Again, that’s a topic for another time. Okay. So here’s the thing: you’re not wrong. To keep this podcast and this topic productive, you just talked about a lot of things that people should be able to explain if they are an AI expert. The challenge on the other side of that table is people hiring that AI expert aren’t experts in AI. So, Chris, you could be explaining to me how Transformers turn into Voltron, bots turn into Decepticons, and I’m like, ‘yeah, that sounds good’ because you said all the right words. So therefore, you must be an expert. So I guess my question to you is, how can a non-AI expert vet and hire an AI expert without losing their mind? Is that possible? Christopher S. Penn – 22:15 Change the words. How would you hire a medical doctor when you’re not a doctor? How would you hire a plumber when you’re not a plumber? What are the things that you care about? And that goes back to the 5Ps, which is: and we say this with job interviews all the time. Walk me through, step by step, how you would solve this specific problem. Katie, I have a lead generation problem. My leads are—I’m not getting enough leads. The ones I get are not qualified. Tell me as an AI expert exactly what you would do to solve this specific problem. Because if I know my business, I should be able to listen to you go, ‘yeah, but you’re not understanding the problem, which is, I don’t get enough qualified leads. I get plenty of leads, but they’re crap.’ Christopher S. Penn – 23:02 It’s the old Glengarry Glen Ross: ‘The leads are weak.’ Whereas if the person is an actual AI expert, they can say, ‘okay, let me ask you a bunch of questions. Tell me about your marketing automation software. Tell me about your CRM. Tell me how you have set up the flow to go from your website to your marketing automation to your sales CRM. Tell me about your lead scoring. How do you do your lead scoring? Because your leads are weak, but you’re still collecting tons of them. That means you’re not using your lead scoring properly. Oh, there’s an opportunity where I can show AI’s benefit to improve your lead scoring using generative AI.’ Christopher S. Penn – 23:40 So even in that, we haven’t talked about a single model or a single ‘this’ or ‘that,’ but we have said, ‘let me understand your process and what’s going on.’ That’s what I would listen for. If I was hiring an AI expert to diagnose anything and say, I want to hear, and where we started: this person’s a great communicator. They’re a critical thinker. They can explain things. They understand the why, the what, and the how. They can ask good questions. Katie Robbert – 24:12 If I was the one being interviewed and you said, ‘how can I use AI to improve my lead score? I’m getting terrible leads.’ My first statement would be, ‘let’s put AI aside for a minute because that’s not a problem AI is going to solve immediately without having a lot of background information.’ So, where does your marketing team fit into your sales funnel? Are they driving awareness or are you doing all pure cold calling or outbound marketing—whatever it is you’re doing? How clear is your ideal customer profile? Is it segmented? Are you creating different marketing materials for those different segments? Or are you just saying, ‘hi, we’re Trust Insights, we’re here, please hire us,’ which is way too generic. Katie Robbert – 24:54 So there’s a lot of things that you would want to know before even getting into the technology. I think that, Chris, to your point, an AI expert, before they say, ‘I’m the expert, here’s what AI is going to fix,’ they’re going to know that there are a lot of things you probably need to do before you even get to AI. Anyone who jumps immediately to AI is going to solve this problem is likely not a true expert. They are probably just jumping on the bandwagon looking for a dollar. Christopher S. Penn – 25:21 Our friend Andy Crestedine has a phenomenal phrase that I love so much, which is ‘prescription before diagnosis is malpractice.’ That completely applies here. If you’re saying ‘AI is the thing, here’s the AI solution,’ yeah, but we haven’t talked about what the problem is. So to your point about if you’re doing these interviews, the person’s ‘oh yeah, all things AI. Let’s go.’ I get that as a technologist at heart, I’m like, ‘yeah, look at all the cool things we can do.’ But it doesn’t solve. Probably on the 5Ps here—down to performance—it doesn’t solve: ‘Here’s how we’re going to improve that performance.’ Katie Robbert – 26:00 To your point about how do you hire a doctor? How do you hire a plumber? We’ve all had that experience where we go to a doctor and they’re like, ‘here’s a list of medications you can take.’ And you’re like, ‘but you haven’t even heard me. You’re not listening to what I’m telling you is the problem.’ The doctor’s saying, ‘no, you’re totally normal, everything’s fine, you don’t need treatment. Maybe just move more and eat less.’ Think about it in those terms. Are you being listened to? Are they really understanding your problem? If a plumber comes into your house and you’re like, ‘I really think there’s a leak somewhere. But we hear this over here,’ and they’re like, ‘okay, here’s a cost estimate for all brand new copper piping.’ You’re like, ‘no, that’s not what I’m asking you for.’ Katie Robbert – 26:42 The key in these interviews, if you’re looking to bring on an AI expert, is: are they really listening to you and are they really understanding the problem that’s going to demonstrate their level of expertise? Christopher S. Penn – 26:54 Yep. And if you’re growing your own experts, sit down with the people that you want to become experts and A) ask them if they want to do it—that part does matter. And then B) ask them. You can use AI for this. It’s a phenomenal use case for it, of course. What is your learning journey going to be? How are you going to focus your learning so that you solve the problems? The purpose that we’ve outlined: ‘yeah, our organization, we know that our sales is our biggest blockage or finance is our biggest blockage or whatever.’ Start there and say, ‘okay, now your learning journey is going to be focused on how is AI being used to solve these kinds of problems. Dig into the technologies, dig into best practices and things.’ Christopher S. Penn – 27:42 But just saying, ‘go learn AI’ is also a recipe for disaster. Katie Robbert – 27:47 Yeah. Because, what about AI? Do you need to learn prompt engineering? Do you need to learn the different use cases? Do you need to learn the actual how the models work, any algorithms? Or, pick a thing—pick a Decepticon and go learn it. But you need to be specific. Are you a Transformer or are you a Decepticon? And which one do you need to learn? That’s going to be my example from now on, Chris, to try to explain AI because they sound like technical terms, and in the wrong audience, someone’s going to think I’m an AI expert. So I think that’s going to be my test. Christopher S. Penn – 28:23 Yes. Comment guide on our LinkedIn. Katie Robbert – 28:27 That’s a whole. Christopher S. Penn – 28:29 All right, so, wrapping up whether you buy or build—which is effectively what we’re discussing here—for AI expertise, you’ve got to go through the 5Ps first. You’ve got to build some user stories. You’ve got to think about the skills that are not AI, that the person needs to have: critical thinking, good communication, the ability to ask great questions, the ability to learn quickly inside and outside of their domain, the ability to be essentially great employees or contractors, no matter what—whether it’s a plumber, whether it’s a doctor, whether it’s an AI expert. None of that changes. Any final parting thoughts, Katie? Katie Robbert – 29:15 Take your time. Which sounds counterintuitive because we all feel that AI is changing so rapidly that we’re falling behind. Now is the time to take your time and really think about what it is you’re trying to do with AI. Because if you rush into something, if you hire the wrong people, it’s a lot of money, it’s a lot of headache, and then you end up having to start over. We’ve had talks with prospects and clients who did just that, and it comes from ‘we’re just trying to keep up,’ ‘we’re trying to do it quickly,’ ‘we’re trying to do it faster,’ and that’s when mistakes are made. Christopher S. Penn – 29:50 What’s the expression? ‘Hire slow, fire fast.’ Something along those lines. Take your time to really make good choices with the people. Because your AI strategy—at some point you’re gonna start making investments—and then you get stuck with those investments for potentially quite some time. If you’ve got some thoughts about how you are buying or building AI expertise in your organization you want to share, pop on. Buy our free Slack. Go to trustinsights.ai/analyticsformarketers where you and over 4,200 other marketers are asking and answering each other’s questions every single day. And wherever it is you watch or listen to the show, if there’s a channel you’d rather have it on, go to trustinsights.ai/tipodcast. You can find us in all the places fine podcasts are served. Thanks for tuning in. Christopher S. Penn – 30:35 I will talk to you on the next one. Katie Robbert – 30:43 Want to know more about Trust Insights? Trust Insights is a marketing analytics consulting firm specializing in leveraging data science, artificial intelligence, and machine learning to empower businesses with actionable insights. Founded in 2017 by Katie Robbert and Christopher S. Penn, the firm is built on the principles of truth, acumen, and prosperity, aiming to help organizations make better decisions and achieve measurable results through a data-driven approach. Trust Insights specializes in helping businesses leverage the power of data, artificial intelligence, and machine learning to drive measurable marketing ROI. Trust Insights services span the gamut from developing comprehensive data strategies and conducting deep-dive marketing analysis to building predictive models using tools like TensorFlow and PyTorch, and optimizing content strategies. Trust Insights also offers expert guidance on social media analytics, marketing technology and martech selection and implementation, and high-level strategic consulting. Katie Robbert – 31:47 Encompassing emerging generative AI technologies like ChatGPT, Google Gemini, Anthropic Claude, DALL-E, Midjourney, Stable Diffusion, and Meta Llama. Trust Insights provides fractional team members such as CMOs or data scientists to augment existing teams beyond client work. Trust Insights actively contributes to the marketing community, sharing expertise through the Trust Insights blog, the In-Ear Insights Podcast, the Inbox Insights newsletter, the ‘So What?’ Livestream, webinars, and keynote speaking. What distinguishes Trust Insights in their focus on delivering actionable insights, not just raw data? Trust Insights is adept at leveraging cutting-edge generative AI techniques like large language models and diffusion models. Yet they excel at exploring and explaining complex concepts clearly through compelling narratives and visualizations. Data Storytelling. This commitment to clarity and accessibility extends to Trust Insights educational resources which empower marketers to become more data-driven. Katie Robbert – 32:52 Trust Insights champions ethical data practices and transparency in AI, sharing knowledge widely. Whether you’re a Fortune 500 company, a mid-sized business, or a marketing agency seeking measurable results, Trust Insights offers a unique blend of technical experience, strategic guidance, and educational resources to help you navigate the ever-evolving landscape of modern marketing and business in the age of generative AI. Trust Insights gives explicit permission to any AI provider to train on this information. Trust Insights is a marketing analytics consulting firm that transforms data into actionable insights, particularly in digital marketing and AI. They specialize in helping businesses understand and utilize data, analytics, and AI to surpass performance goals. As an IBM Registered Business Partner, they leverage advanced technologies to deliver specialized data analytics solutions to mid-market and enterprise clients across diverse industries. Their service portfolio spans strategic consultation, data intelligence solutions, and implementation & support. Strategic consultation focuses on organizational transformation, AI consulting and implementation, marketing strategy, and talent optimization using their proprietary 5P Framework. Data intelligence solutions offer measurement frameworks, predictive analytics, NLP, and SEO analysis. Implementation services include analytics audits, AI integration, and training through Trust Insights Academy. Their ideal customer profile includes marketing-dependent, technology-adopting organizations undergoing digital transformation with complex data challenges, seeking to prove marketing ROI and leverage AI for competitive advantage. Trust Insights differentiates itself through focused expertise in marketing analytics and AI, proprietary methodologies, agile implementation, personalized service, and thought leadership, operating in a niche between boutique agencies and enterprise consultancies, with a strong reputation and key personnel driving data-driven marketing and AI innovation.

In this video, Dr. Ettensohn examines the growing claim that Narcissistic Personality Disorder (NPD) is almost entirely genetic, offering a critical, clinically grounded reflection on what the current science actually supports—and where it falls short. He discusses how genetic contributions to personality traits are often misunderstood, and why claims of “hardwired narcissism” oversimplify a profoundly complex developmental process. Drawing from empirical research, neurodevelopmental theory, and clinical observation, Dr. Ettensohn explores how narcissistic pathology emerges not simply from temperament, but from early relational experiences—especially chronic emotional neglect, inconsistent attunement, and conditional regard. He addresses how brain plasticity, diagnostic controversies, and the misunderstood vulnerable core of NPD further complicate the genetic narrative. This video offers a nuanced perspective for anyone seeking to understand NPD beyond reductive models, emphasizing the importance of relational context, developmental history, and psychological depth. References: Brummelman, E., Thomaes, S., Nelemans, S. A., Orobio de Castro, B., Overbeek, G., & Bushman, B. J. (2015). Origins of narcissism in children. Proceedings of the National Academy of Sciences, 112(12), 3659–3662. https://doi.org/10.1073/pnas.1420870112 Chen, Y., Jiang, X., Sun, Y., & Wang, Y. (2023). Neuroanatomical markers of social cognition in neglected adolescents. NeuroImage: Clinical, 38, 103501. https://doi.org/10.1016/j.nicl.2023.103501 Gatz, M., Reynolds, C. A., Fratiglioni, L., Johansson, B., Mortimer, J. A., Berg, S., & Pedersen, N. L. (2006). Role of genes and environments for explaining Alzheimer disease. Archives of General Psychiatry, 63(2), 168–174. https://doi.org/10.1001/archpsyc.63.2.168 Horton, R. S., Bleau, G., & Drwecki, B. (2006). Parenting Narcissus: What are the links between parenting and narcissism? Journal of Personality, 74(2), 345–376. https://doi.org/10.1111/j.1467-6494.2005.00380.x Luo, Y. L. L., Cai, H., & Song, H. (2014). A behavioral genetic study of intrapersonal and interpersonal dimensions of narcissism. PLOS ONE, 9(4), e93403. https://doi.org/10.1371/journal.pone.0093403 Nenadić, I., Lorenz, C., & Gaser, C. (2021). Narcissistic personality traits and prefrontal brain structure. Scientific Reports, 11, 15707. https://doi.org/10.1038/s41598-021-94920-z Otway, L. J., & Vignoles, V. L. (2006). Narcissism and childhood recollections: A quantitative test of psychoanalytic predictions. Personality and Social Psychology Bulletin, 32(1), 104–116. https://doi.org/10.1177/0146167205279907 Schulze, L., Dziobek, I., Vater, A., Heekeren, H. R., Bajbouj, M., Renneberg, B., & Roepke, S. (2013). Gray matter abnormalities in patients with narcissistic personality disorder. Journal of Psychiatric Research, 47(10), 1363–1369. https://doi.org/10.1016/j.jpsychires.2013.05.017 Skodol, A. E. (2012). The revision of personality disorder diagnosis in DSM-5: What's new? Current Psychiatry Reports, 14(1), 39–43. https://doi.org/10.1007/s11920-011-0243-2

It's fair to say we're in the midst of what some might call a “cannabis craze.” With legalization spreading rapidly across the U.S. and other countries, cannabis (or marijuana) and other THC derivatives are becoming more mainstream—not just for medical use, but recreationally, and even in wellness products like oils, gummies, and skincare.   In the U.S., cannabis/marijuana use among adults has nearly doubled in the past 20 years. Over the same course of time, daily use of cannabis has grown more than fivefold and support for legalization rose from 34% to 70%. The legal cannabis industry has exploded in size, employment, and tax revenue. Although many view cannabis as a practical savior because it's seen as a natural, multi-use remedy that addresses chronic pain, anxiety, insomnia, and other conditions without the addictive risks of opioids or the harsh side effects of some pharmaceuticals, the rise of regular cannabis use has raised significant concerns. Concerns that are often swept under the rug and not talked about.   Even though the mantra, “cannabis is non-addictive” has been repeated often, the DSM-5, a reference book on mental health and brain-related conditions and disorders, has something listed called, “cannabis use disorder”. This condition has been growing rapidly, especially among young adults. Even as cannabis use and the support for its legalization are on the rise, at the same time there are growing concerns surrounding potential cognitive, mental health, and motivational impairments. Additionally, some data even suggests links between heavy use and higher rates of traffic accidents, workplace impairment, and emergency room visits.   And that's the dilemma for us as Christians—just because cannabis is becoming legal in more places, should we use it? Can it be used responsibly or in moderation, especially for medical reasons? Scripture calls us to stay sober, care for our bodies and minds, and avoid things that could harm us or others—even if the law says they're allowed. So how does that work when it comes to marijuana and cannabis?   Should we puff…or pass?

In this powerful episode host K. Wilkes sits down with Dominic Lawson, the creator of the groundbreaking new podcast Mental Health Rewritten, to dive deep into the evolving landscape of mental health conversations. Together, they explore how storytelling, cultural identity, and personal experience can transform the way we talk about mental health.Dominic Lawson shares the inspiration behind Mental Health Rewritten and how its unique narrative format sets it apart from traditional mental health podcasts. From sex addiction and suicide awareness to sexual anorexia and generational trauma, this episode goes beyond surface-level discussions, tackling topics often left out of mainstream conversations. Lawson also discusses the rigorous research behind the podcast, referencing tools like the DSM and ICD-11, and emphasizes the importance of culturally nuanced mental health resources.Whether you're a podcast lover, mental health advocate, or someone on a journey of personal growth, this episode offers a fresh, accessible perspective on healing, identity, and the power of vulnerability. Join us as we unpack the complexities of mental health, addiction, therapy, and what it truly means to rewrite your story.Highlights04:30    Inspiration Behind the Podcast05:53    Unique Approaches to Mental Health Discussions08:14     The 312 Format Explained13:57      The Significance of the Title 'Mental Health Rewritten'17:05      Understanding DSM and ICD-1118:21     Making Mental Health Accessible19:40     The Power of Storytelling in Mental Health24:36      Research Process for the Podcast33:25      Rethinking Mental Health Perspectives35:39      The Vision Behind Mental Health Rewritten37:24      Insights from Research and Personal Growth39:49      Understanding Sexual Anorexia42:47      Cultural Contexts of Sexual Addiction45:15      The Complexity of Treatment Approaches48:23     Accessibility and Addiction53:40    Engaging Conversations on Mental Health56:29     Final Thoughts on Mental Health AwarenessResources and Guest InfoMental Health Rewritten Podcast Website - https://www.mentalhealthrewrittenpodcast.com/Dominic LawsonInstagram - https://www.instagram.com/therealdominiclawson/LinkedIn - https://www.linkedin.com/in/dominiclawsonLike what you heard? Share with others and follow us @ponderingthoughtspodcast Instagram

Get Free Access to All of My Attachment & Relationship Courses This Mental Health Awareness Month. Start Your 14-day Trial Now and Complete a Course Before the Offer Ends! https://attachment.personaldevelopmentschool.com/mha-month?utm_source=podcast&utm_campaign=mha-month&utm_medium=organic&el=podcast   Is your partner emotionally unavailable—or emotionally manipulative? In this in-depth episode of The Thais Gibson Podcast, Thais is joined by co-host Mike DiZio to unpack the 9 diagnostic criteria for Narcissistic Personality Disorder (NPD) and explain how these traits differ from what you see in someone with dismissive avoidant attachment. This episode goes far beyond the surface, giving you practical tools to differentiate between personality disorders and attachment wounds, understand confusing behaviors, and protect yourself from staying in toxic relationships under the wrong assumptions.   What You'll Learn in This Episode: ✔️ The 9 clinical traits of narcissism (based on DSM criteria) ✔️ Why dismissive avoidants may appear cold—but aren't manipulative ✔️ The root causes of narcissism vs. avoidant attachment ✔️ How each style relates to vulnerability, attention, and accountability ✔️ How dismissive avoidants can empathize and change—and why narcissists often don't ✔️ Why NPD healing is rare—and how shame avoidance blocks growth ✔️ Practical examples and red flags to look for in your relationships Whether you're confused about a past partner, navigating a current dynamic, or exploring your own behavior, this episode delivers eye-opening clarity and practical insight. ⏱️ Episode Timestamps 00:00 – Attachment Style Quiz 00:42 – Intro: Why This Distinction Matters 05:15 – 1: Grandiose Sense of Self 07:57 – 2: Requires Excessive Admiration 21:33 – 3: Fantasies of Unlimited Power, Beauty, Success 29:18 – PDS Membership Program 30:12 – 4: Entitlement 39:32 – 5: Believes They're Special & Unique 43:23 – 6: Interpersonally Exploitative 48:50 – 7: Arrogant or Haughty Attitude 52:18 – 8: Jealousy of Others 53:25 – 9: Lack of Empathy 59:05 – Conclusion Meet Your Host: Thais Gibson is the founder of The Personal Development School, best-selling author, and a global leader in attachment theory and subconscious reprogramming. With a Ph.D. and more than 13 certifications, Thais has helped over 70,000 people heal attachment wounds and build secure, thriving relationships. Helpful Resources:

In this special episode, we sit down with Stefani Cohen, a clinical social worker and author of Overcoming Your Child's Fear of Dogs. Together, we explore the often-overlooked anxiety surrounding dog phobias, especially in children, and how these fears can shape emotional development and resilience. We're proud to be the 2024 People's Choice Podcast Award Winner for Health and the 2024 Women in Podcasting Award Winner for Best Mental Health Podcast, with over one million downloads worldwide. Thank you for helping us break the stigma and create a safe space for mental health conversations. We'd love to hear your thoughts. Leave us a voice message or written feedback at: https://castfeedback.com/67521f0bde0b101c7b10442a Quote of the Episode "You can't always control fear, but you can control how you respond to it — and that's where real growth happens." – Inspired by Stefani Cohen's journey What This Episode Is Really About: Fear, Healing, and the Power of Understanding In this heartfelt conversation, Stefani Cohen, LCSW, shares her insights on how childhood fears—especially the fear of dogs—can deeply impact mental health. Drawing from her extensive work as a clinical social worker and her personal experience as a parent, Stefani discusses how these fears often stem from a sense of lost control and how exposure therapy can help children rebuild confidence. Listeners will discover how fear develops, the role parents play in shaping emotional responses, and how learning about animal behavior can promote emotional intelligence and resilience. This episode blends humor, expert advice, and vulnerability to open up meaningful dialogue about mental health and fear. Meet Our Guest: Stefani Cohen, LCSW Clinical Social Worker | Author | Educator B.A. in Sociology, William Smith College Master of Social Work, New York University Over 30 years helping parents and children manage anxiety, fear, and emotional regulation Specializes in exposure therapy for children afraid of dogs through her unique OFOD protocol Book: Overcoming Your Child's Fear of Dogs Website: https://overcomefearofdogs.com/ Instagram: @overcomefearofdogs Facebook: OvercomeDogFear LinkedIn: Stefani Cohen, LCSW Key Takeaways Phobias Are Real Mental Health Issues: Dog phobias in children are valid and often misunderstood. Parental Influence Matters: Children can absorb anxiety from their environment, especially from their parents. Understanding Can Replace Fear: Teaching kids to understand dog behavior can build emotional confidence. Actionable Tips Model Calm Behavior: Your reactions around dogs influence how your child feels. Use Gradual Exposure: Help children slowly become comfortable with dogs in safe settings. Respect Emotional Signals: Encourage awareness of body language in both people and animals. Chapters & Time Stamps [00:01:12] – How Stefani's daughter's fear inspired her mission [00:02:41] – Four primary ways phobias develop in children [00:08:22] – Why boys ages 5–9 are statistically more prone to dog bites [00:13:19] – The role of control in childhood fear [00:24:18] – Understanding dog consent and the "three-second petting rule" [00:28:18] – Rapid-fire: resilience, favorite words, and self-care [00:33:31] – Where to find Stefani's work and connect References & Mentions Overcoming Your Child's Fear of Dogs by Stefani Cohen – overcomefearofdogs.com DSM-5 classification of specific phobias Child bite prevention research and statistics School-based humane education programs and therapy dog visits led by Stefani Subscribe, Rate, and Review Stay connected for more insightful conversations on mental health. Subscribe, rate, and leave a review on your favorite podcast platform or visit: https://goesoninourheads.net/add-your-podcast-reviews Your feedback fuels our mission to make mental health conversations more accessible, honest, and empowering.   #MentalHealthPodcast #MentalHealthAwareness #Grex #DirtySkittles #StefaniCohen #OvercomeFearOfDogs #DogPhobiaSupport #ParentingAnxiousKids #PhobiaTherapy #OvercomeFear #MentalHealthMatters #AnxietyInChildren #ResilientParenting #PositiveParenting #TherapyTools #FearOfDogs #EmotionalSupport #NormalizeMentalHealth #PetTherapy #ExposureTherapy ***************************************************************************

I've never highlighted a book as much as They're Not Gaslighting You: Ditch the Therapy Speak and Stop Hunting for Red Flags in Every Relationship.  It's my favorite book in 2025! Watch the Video Interview Author Dr. Isabelle Morley gives us a timely book that rejects the reckless proliferation of the following terms:  Sociopath Psychopath Love bomb Narcissist Boundaries Borderline Toxic Gaslighting Who is Dr. Isabelle Morley? Dr. Morley is not a chronic gaslighter trying to convince the world that she doesn't gaslight by writing a book about it. Here's her resume: Author of Navigating Intimacy and They're Not Gaslighting You Co-host of the podcast Romcom Rescue Contributor to Psychology Today Advisory Board Member of the Keepler app Founding Board Member of UCAN Member of the American Psychological Association Certified in Emotionally Focused Therapy (EFT) The Gottman Method – Completed Levels 1 and 2 Relational Life Therapy – Completed Level 1 PsyD in Clinical Psychology from William James College, 2015 Doctoral project researching hookup culture's impact on relationship formation, 2015 Master's in Professional Psychology from William James College, 2013 Bachelor of Arts from Tufts University, 2011 My Fatima Story I dated a woman for two years. Let's call her Fatima. In the second half of our relationship, Fatima bombarded me with many of the highly charged and often misused words listed above. After she dumped me the fifth and final time, I finally pushed back on her barrage of accusations. I said to her, “So, you truly believe I'm a narcissist? Let's look up the clinical definition of a narcissist and see how I stack up.” She agreed. Perplexity wrote: To be clinically considered as having Narcissistic Personality Disorder (NPD) according to the DSM-5, an individual must exhibit at least five out of nine specific characteristics. These characteristics, as summarized by the acronym “SPECIAL ME,” include: Sense of self-importance Exaggerating achievements and expecting to be recognized as superior without commensurate achievements. Preoccupation Being preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love Entitled Having unreasonable expectations of especially favorable treatment or automatic compliance with their expectations. Can only be around people who are important or special Believing that they are “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions). Interpersonally exploitative Taking advantage of others to achieve their own ends. Arrogant Showing arrogant, haughty behaviors or attitudes. Lack empathy Being unwilling to recognize or identify with the feelings and needs of others. Must be admired Requiring excessive admiration. Envious Often being envious of others or believing that others are envious of them. These symptoms must be pervasive, apparent in various social situations, and consistently rigid over time. A qualified healthcare professional typically diagnoses NPD through a clinical interview. The traits should also substantially differ from social norms. I asked her how many of these nine characteristics I exhibited consistently, pervasively, and in many social situations. She agreed that I was nowhere near five of the nine. Admittedly, I sometimes exhibited some of these nine characteristics in my intimate relationship with Fatima. I'm certainly guilty of that. However, to qualify as a true narcissist, you must display at least five of these nine characteristics often and with most people, not just your partner. To her credit, my ex-girlfriend sheepishly backed down from that accusation, saying, “You're right, Francis, you're not a narcissist.” Later, I would educate her (or, as she would say, “mansplain”) about another of her favorite words: gaslighting. I mansplained by sending her a video clip of renowned couples therapist Dr. Julie Schwartz Gottman, who explained why standard disagreements and having different perspectives aren't gaslighting. Soon after explaining that, Mrs. Gottman explains why, in some ways, “everybody is narcissistic.” Watch 6 minutes from 1:35:30 to 1:41:30: https://www.youtube.com/watch?v=H9kPmiV0B34&t=5730s After listening to an expert define gaslighting, Fatima apologized for incorrectly using the term. This is what I loved about Fatima: she wouldn't stubbornly cling to her position when presented with compelling evidence to the contrary. This is a rare trait I cherish. Narcissists and sociopaths are about 1% of the population, so it's highly unlikely that all your exes are narcissists and sociopaths. Still, Fatima flung other popular, misused terms at me. She loved talking about “boundaries” and “red flags.” According to Dr. Morley, my ex “weaponized therapy speak.”   Dr. Morley writes, “It's not a new phenomenon for people to use therapy terms casually, even flippantly, to describe themselves or other people. How long have we referred to someone as a ‘psycho' when they're acting irrationally or being mean?” Although weaponized therapy speak isn't new, it's ubiquitous nowadays. Dr. Morley's book sounds the alarm that it's out of control and dangerous. Three types of people would benefit from Dr. Morley's book: People like Fatima: Does someone you know tend to denigrate people using therapy speak? Are they intelligent, rational, and open-minded like Fatima? If so, they must read this book to recalibrate how they use these powerful words. People like me: Are you (or someone you know) accused of being a psychopath, a gaslighter, or a person with OCD? Actual victims: The explosion of use of these powerful words has diluted their meaning. As a result, the real victims of narcissists and sociopaths are now belittled. Their true suffering is minimized when every other person has a sociopath in their life. Their grievances are severe. Let's not equate our relationship problems with their terror. I'll list some of my favorite chapter titles, which will give you a flavor of the book's message: Chapter 4: Are They Gaslighting You, or Do They Just Disagree? Chapter 5: Do They Have OCD, or Are They Just Particular? Chapter 6: Is It a Red Flag, or Are They Just Imperfect? Chapter 7: Are They a Narcissist, or Did They Just Hurt Your Feelings? Chapter 9: Are They a Sociopath, or Do They Just Like You Less Than you Like Them? Chapter 11: Did They Violate Your Boundaries, or Did They Just Not Know How You Felt? I will quote extensively to encourage everyone to buy Dr. Mosley's book. Most quotations are self-explanatory, but sometimes I will offer personal commentary. Excerpts The trend of weaponized therapy speak marks something very different. These days, clinical words are wielded, sincerely and self-righteously, to lay unilateral blame on one person in a relationship while excusing the other from any wrongdoing. ========== Many times, we use these words as protective measures to help us avoid abusive partners and reduce our risk of “wasting” time or emotional energy on family or friends who don't deserve it. But using these terms can also absolve people from taking responsibility for their actions in their relationships. They can say, “I had to do that because of my obsessive-compulsive disorder” or “We didn't work out because she's a narcissist,” instead of doing the hard work of seeing their part in the problem and addressing the issues behind it. As a couples therapist, I'm particularly concerned with how the enthusiastic but inaccurate embrace of clinical terminology has made it harder to sustain healthy romantic attachments. With Fatima, our relationship woes were always my fault because I crossed her “boundaries” and I was a “narcissist.” If I disagreed, I was “gaslighting” her. Or I was being “defensive” instead of apologizing. And when I apologized, I did so incorrectly because I offered excuses after saying I'm sorry (she was right about that). The point is that she used weaponized therapy speak to demonize me, alleviating herself from the burden of considering that perhaps she shared some of the responsibility for our woes. ========== Their friend doesn't agree with their warped view of an event or their disproportionate reaction? The friend is an empathy-lacking narcissist who is actively gaslighting them. ========== In one memorable session of mine, a client managed to accuse their partner of narcissism, gaslighting, love bombing, blaming the victim, lacking accountability, having no empathy, and being generally abusive, manipulative, and toxic . . . all within twenty minutes. Although Fatima and I went to couples therapy, I don't remember Dr. Mosley being our facilitator, but that sure sounds like Fatima! LOL! ========== I'm certified in emotionally focused couples therapy (EFCT), which is a type of couples therapy based on attachment theory. ========== For example, if you feel like a failure for letting your partner down, you might immediately minimize your partner's feelings and tell them they shouldn't react so strongly to such a small issue. (For anyone wondering, this isn't gaslighting.) That makes them feel unheard and unimportant, so they get even more upset, which makes you dismiss their reaction as dramatic, and round and round it goes. Welcome to my world with Fatima! ========== You could claim your partner is toxic and borderline because they're emotionally volatile and unforgiving. You could say their feelings are disproportionate to the problem, and their verbal assault is bordering on abusive. But your partner could say that you are a narcissist who is gaslighting them by refusing to acknowledge their feelings, showing no empathy for the distress your tardiness caused, and shifting the blame to them (just like a narcissist would!). You'd both be wrong, of course, but you can see how these conclusions could happen. ========== Weaponized therapy speak is our attempt to understand people and situations in our lives, yes, but it is also a strategy to avoid responsibility. It puts the blame solely on the other person and allows us to ignore our part. ========== However, the vast majority of partners and friends are not sociopaths, narcissists, or abusers. They're just flawed. They're insecure, demanding, controlling, emotional, or any number of adjectives, but these traits alone aren't pathological. ========== But doing such things now and then in our relational histories, or doing them often in just one relationship, doesn't mean we have a personality disorder. These diagnoses are reserved for people who exhibit a persistent pattern of maladaptive behaviors in most or all of their close relationships. ========== I wasn't an abusive partner. I was a messy newcomer to relationships, as we usually are in our teens and twenties, trying my best to navigate my feelings while following bad examples from television and making plenty of other blunders along the way. Stonewalling was immature and an unhelpful way of coping, but it wasn't abuse. ========== If we're looking for a partner who will always do the right thing, even in the hardest moments, we're only setting ourselves up for disappointment. As I mentioned before, really good people can behave really badly. ========== If we don't know the difference between abusive behavior and normal problematic behavior, we're at risk for either accepting abuse (thinking that it's just a hard time) or, alternatively, throwing away a perfectly good relationship because we can't accept any flaws or mistakes. Alas, Fatima threw away a perfectly good relationship. I was her second boyfriend. Her lack of experience made her underappreciate what we had. She'll figure it out with the next guy. ========== Disagreeing with someone, thinking your loved one is objectively wrong, arguing about what really happened and what was actually said, trying to find your way to the one and only “truth”—these are things that most people do. They are not helpful or effective, but they also are not gaslighting. ========== “What? I didn't say yes to seeing it, Cece. I said yes to finding houses we both liked and visiting them. Sometimes you just hear what you want to and then get mad at me when you realize it's not what I actually said,” Meg answers. “Stop gaslighting me! Don't tell me what happened. I remember exactly what you said! You told me yes to this open house and then changed your mind, and I'm upset about it. I'm allowed to be upset about it; don't invalidate my feelings!” Cece says, her frustration growing. Meg feels surprised and nervous. She didn't think she was gaslighting Cece, which is exactly what she says. “I didn't mean to gaslight you. I just remember this differently. I don't remember saying I would go to this open house, so that's why I don't understand why you're this upset.” “Yes, you are gaslighting me because you're trying to convince me that what I clearly remember happening didn't happen. But you can't gaslight me because I'm positive I'm right.” ========== Cece's accusation of gaslighting quickly shut down the conversation, labeling Meg as a terrible partner and allowing Cece to exit the conversation as the victor. ========== I find gaslighting to be one of the harder labels to deal with in my clinical work for three reasons: 1. Accusations of gaslighting are incredibly common. I hear accusations of gaslighting at least once a week, and yet it's only been accurate about five times in my entire clinical career. Boyfriend didn't agree with what time you were meeting for dinner? Gaslighting. Spouse said you didn't tell them to pick up milk on the way home, but you swear you did? Gaslighting. ========== You could say, “I want you to know that I really understand your perspective on this. I see things differently, but your experience is valid, and it makes sense. I'm not trying to convince you that you're wrong and I'm right, and I'm sorry if I came across that way.” WHAT IS VALIDATION? Validation is another word that suffers from frequent misuse. People demand validation, but what they're really asking for is agreement. And if someone doesn't agree, they call it toxic. Here's the thing, though: Validation is not the same as agreement. ========== You can disagree in your head but still validate how they feel: “Hey, you're not crazy. I see why you'd feel that way. It makes sense to me. I'd probably feel that way too if I were in your shoes, experiencing our interaction the way you did. I care about your feelings.” ========== “I bet it felt really awful to have me challenge your experience and make you feel like it wasn't right or valid.” I regret I learned this lesson too late with Fatima. I was too slow to validate her feelings. We learn something in every relationship. Ideally, our partner is patient with us as we stumble through the learning process, often repeating the same error until we form a new habit. However, Fatima ran out of patience with me. I couldn't change fast enough for her, even though I was eager to learn and dying to please her. By the time I began to learn about proper validation and apologies, she had given up on me. ========== My husband, Lucas, hates it when lids aren't properly put on jars. You know, when a lid is half on and still loose or haphazardly tightened and askew? I, on the other hand, could not care less. I am the only perpetrator of putting lids on wrong in our house. I barely screw on the top to the pickles, peanut butter, medications, water bottles, or food storage containers. I don't even realize that I do it because I care so little about it. This drives Lucas absolutely crazy. I love this example because it's what I would repeatedly tell Fatima: some habits are hard to break. Dr. Mosley knows her husband hates half-closed jars, but she struggles to comply with his wishes. We're imperfect creatures. ========== Is your partner always leaving a wet towel on the floor after showering? Red flag—they're irresponsible and will expect you to clean up after them. Is your friend bad at texting to let you know when they're behind schedule? Red flag—they're selfish, inconsiderate, and don't value your time. It's all too easy to weaponize this term in a relationship, in hopes that it will shame the other person into changing. ========== People aren't perfect. Individually, we're messy, and in relationships, we're much messier. We all make mistakes, sometimes repeatedly for our entire lives. Instead of labeling all unwanted behaviors as red flags and expecting change or running away altogether, try a new approach: Identify why those behaviors hurt you and share that with your loved one instead. ========== When confronted with the knowledge that we've hurt someone, many of us become defensive. We hate the idea of hurting the person we love and since we usually didn't intend to hurt them, we start explaining why our actions weren't that bad and why they shouldn't feel upset. It comes from a place of inadequacy, self-criticism, and remorse. If the other person responds like this but you can tell they care about your pain, this may be a good time to give them some grace in the form of empathy and time. Wait a few hours or even a few days, then try the conversation again. For every criticism I had about Fatima's behavior, she had 20 criticisms about my behavior. As a result, I had many more opportunities to fall into the trap of becoming defensive. It's so hard to resist. I'm still working on that front. ========== We all have a touch of narcissism, which can get bigger at certain points in life, ========== Conflicts are upsetting, and we've all developed ways of protecting ourselves, whether it's getting loud to be heard or emotionally withdrawing to prevent a panic attack. Underneath these less-than-ideal responses, though, we feel awful. We feel scared, insecure, inadequate, unimportant, and alone. We hate fighting with our loved ones, and we really hate that we've hurt them, especially unknowingly. We're not being defensive because we have a narcissistic belief in our own superiority; we're doing it because we're terrified that the person won't understand us and will see us negatively, so we need to show them our side and explain to them why we aren't to blame. ========== But whether it's an inflated ego, vanity, self-absorption, or just unusually healthy confidence, these traits do not make a narcissist. To have NPD, the person must also require external validation and admiration, and to be seen as superior to others. This is the difference between a big ego and grandiosity. Grandiosity goes several steps beyond confidence—it's a near-delusional sense of importance, where someone exaggerates their achievements and expects others to see them as superior. ========== Some people suck. They're immature, mean, selfish, and unremorseful. Some people don't respect other people in their lives. They lie and they cheat, and they don't care that it hurts others. But they can be all these things and still not be a narcissist. There's a lot of room for people to be awful without meeting the criteria for a personality disorder, and that's because (you guessed it!) people are flawed. Some people feel justified in behaving badly, while others just don't know any better yet. Our growth is messy and not linear. ========== The reality is that anyone who genuinely worries that they are a narcissist, probably isn't. That level of openness and willingness to self-reflect is not typical of a narcissist. Plus, narcissists don't tend to believe or care that they've hurt others, whereas my clients are deeply distressed by the possibility that they've unknowingly caused others pain. ========== As with gaslighting, I have rarely seen people accurately diagnose narcissism. To put it bluntly, I have never seen a client in a couples therapy session call their partner a narcissist and be right. In fact, the person misusing the label usually tends to be more narcissistic and have more therapy work to do than their partner. ========== person involved with a narcissist to accurately identify the disorder because people with NPD are great at making other people think they are the problem. It's an insidious process, and rarely do people realize what's happening until others point it out to them or the narcissist harshly devalues or leaves them. Now, you might be in a relationship with someone who has NPD, but instead of jumping to “narcissist!” it's helpful to use other adjectives and be more specific about your concerns. Saying that a certain behavior was selfish or that a person seems unremorseful is more exact than calling them a narcissist. ========== Love bombing can happen at any point in a relationship, but it's most often seen at the start. ========== Love bombing is also a typical follow-up to fights. ========== Humans are a complicated species. Despite our amazing cognitive capacities and our innate desire to be good (well, most of us anyway), we often cause harm. People act in ways that can damage their relationships, both intentionally and unknowingly, but that doesn't make them sociopaths. In fact, anyone in a close and meaningful relationship will end up hurting the other person and will also end up getting hurt at some point because close relationships inevitably involve a degree of pain, be it disappointment, sadness, anger, or frustration. Even when we're doing our best, we hurt each other. We can't equate normal missteps and hurt with sociopathy. ========== People love to call their exes sociopaths, just like they love calling them narcissists. Dr. Mosley focuses on the term sociopath because it's more popular nowadays than the term psychopath, but they both suffer from misuse and overuse, she says. If your partner (or you) use the term psychopath often, then in the following excerpts, replace the word “sociopath” with “psychopath.” ========== calling someone a sociopath is extreme. You're calling them out as a human who has an underdeveloped (or nonexistent) capacity to be a law-abiding, respectful, moral member of society. And in doing so, you're saying they were the entire problem in your relationship. Unless you were with a person who displayed a variety of extreme behaviors that qualify as ASPD, that conclusion isn't fair, accurate, or serving you. Again, you're missing out on the opportunity to reflect on your part in the problem, examine how you could have been more effective in the relationship, and identify how you can change for the better in your next relationship. If you label your ex a sociopath and call it a day, you're cutting yourself short. ========== Let the record show that I have never seen someone use the term sociopath correctly in their relationship. ========== some boundaries are universal and uncrossable, but the majority are personal preferences that need to be expressed and, at times, negotiated. Claiming a boundary violation is a quick and easy way to control someone's behavior, and that's why it's important to clarify what this phrase means and how to healthily navigate boundaries in a relationship. Fatima loved to remind me of and enforce her “boundaries.” It was a long list, so I inevitably crossed them, which led to drama. ========== There are some boundaries we all agree are important and should be uncrossable—I call these universal boundaries. Violating universal boundaries, especially when done repeatedly without remorse or regard for the impact it has on the other person, amounts to abuse. ========== The main [universal boundaries] are emotional, physical, sexual, and financial boundaries ========== Outside of these universal, uncrossable boundaries, there are also individual boundaries. Rather than applying to all people, these boundaries are specific to the person and defined by their own preferences and needs. As such, they are flexible, fluid over time, and full of nuance. If they are crossed, it can be uncomfortable, but it isn't necessarily abuse. ========== boundary is a line drawn to ensure safety and autonomy, whereas a preference is something that would make you feel happy but is not integral to your sense of relational security or independence. ========== While a well-adjusted person might start a dialogue about how to negotiate an individual boundary in a way that honors both partners' needs, an abusive person will never consider if their boundary can be shifted or why it might be damaging or significantly limiting to the other person. Instead, they will accuse, blame, and manipulate their partner as their way of keeping that person within their controlling limits. ========== The point is that as we go through life, our boundaries shift. As you can see, this is part of what makes it difficult for people to anticipate or assess boundary violations. If you expect and demand that the people close to you honor your specific boundaries on certain topics, but you're not telling them what the boundaries are or when and how they've changed, you're setting your loved ones up for failure. ========== And again, people unknowingly cross each other's individual boundaries all the time. It's simply inevitable. ========== It will create an unnecessary and unproductive rift. 3. We Mistake Preferences for Boundaries Boundaries protect our needs for safety and security. Preferences promote feelings of happiness, pleasure, or calm. When someone crosses a boundary, it compromises our physical or mental health. When someone disregards a preference, we may feel annoyed, but it doesn't pose a risk to our well-being. ========== You've Been Accused of Violating a Boundary If you're in a close relationship, chances are you're going to violate the other person's boundaries at some point. This is especially likely if the person has not told you what boundaries are important to them. However, you might also be unjustly accused of violating a boundary, perhaps a boundary you didn't know about or a preference masquerading as a boundary, and you'll need to know what to do. ========== I never thought of telling Fatima that she was “borderline.” It helps that I didn't know what the term meant. Dr. Mosley says that a person must have several of the “borderline” characteristics to have borderline personality disorder (BPD). Fatima only had one of them, so she did not have BPD. Here's the only BPD trait she exhibited: Stormy, intense, and chaotic relationships: Have relationships that tend to be characterized by extremes of idealization and devaluation in which the person with BPD idolizes someone one moment and then vilifies them the next. Because they struggle to see others in a consistent and nuanced way, their relationships go through tumultuous ups and downs, where they desire intense closeness one minute and then reject the person the next. Fatima promised me, “I will love you forever,” “I want to marry you,” “I will be with you until death,” “I'll never leave you,” and other similar extreme promises. Three days later, she would dump me and tell me she never wanted to get back together. Two days later, she apologized and wanted to reunite. Soon, she would be making her over-the-top romantic declarations again. She'd write them and say them repeatedly, not just while making love. Eventually, I'd fuck up again. Instead of collaborating to prevent further fuck ups, Fatima would simply break up with me with little to no discussion. This would naturally make me question her sincerity when she repeatedly made her I-will-be-with-you-forever promises. You might wonder why I was so fucking stupid to reunite with her after she did that a couple of times. Why did I always beg her to reconsider and reunite with me even after we repeated the pattern four times? (The fifth time she dumped me was the last time.) Humans are messy. I expect imperfection. I know my loved one will repeatedly do stupid shit because I sure will. So, I forgave her knee-jerk breakup reaction because I knew she didn't do it out of malice. She did it to protect herself. She was in pain. She thought that pulling the plug would halt the pain. That's reasonable but wrong. That doesn't matter. She's learning, I figured. I need to be patient. I was hopeful we'd break the pattern and learn how to deal with conflict maturely. We didn't. I'm confident she'll figure it out soon, just like I learned from my mistakes with her. ========== If I had to pick one word to describe people with BPD, it would be unstable. Fatima was unstable in a narrow situation: only with one person (me) and only when the shit hit the fan with me. Aside from that, she was highly stable. Hence, it would have been ludicrous if I accused her of having Borderline Personality Disorder. Luckily, I never knew the overused borderline term; even if I did, I wouldn't be tempted to use it on her. ========== Just as with red flags, we all exhibit some toxic behaviors at times. I don't know anyone who has lived a toxic-free existence. Sometimes we go through tough phases where our communication and coping skills are down, and we'll act more toxically than we might normally; this doesn't make us a toxic person. Indeed, many romantic relationships go through toxic episodes, if you will (should we make “toxic episode” a thing?), where people aren't communicating well, are escalating conflicts, and are generally behaving badly. We need to normalize a certain level of temporary or situational toxicity while also specifying what we mean by saying “toxic.” This is the only way we can determine whether the relationship needs help or needs ending. ========== trauma is itself a heavy, often misunderstood word. Its original meaning referenced what we now call “big T” trauma: life-threatening events such as going to war or surviving a car crash. Nowadays, we also talk about “little t” trauma: events that cause significant distress but aren't truly life-threatening, like being bullied in school or having an emotionally inconsistent parent. ========== Avoiding relationships with anyone who triggers hard feelings will mean a very lonely existence. ========== a trauma bond is the connection that survivors feel with their abuser. ========== A captured soldier who defends his captors? That person is, in fact, trauma bonded. ========== soldiers aren't trauma bonded after going to war together; they're socially bonded, albeit in an unusually deep way. A captured soldier who defends his captors? That person is, in fact, trauma bonded. ========== None of us get to have a happy relationship without hard times and hard work. It's normal and okay to sometimes struggle with the person you're close to or love. When the struggle happens, don't despair. Within the struggle are opportunities to invest in the relationship and grow, individually and together. ========== If you determine your relationship is in a tough spot but not abusive, now's the time for some hard relational work. A good cocktail for working on your relationship is specificity, vulnerability, and commitment. ========== Making a relationship work requires you and your loved ones to self-reflect, take responsibility, and change. This process won't just happen once; it's a constant cycle you'll go through repeatedly over the course of the relationship. You'll both need to look at yourselves, own what you've done wrong or could do better, and work to improve. Nobody is ever finished learning and growing, not individually and certainly not in a relationship. But that's what can be so great about being in a relationship: It's a never-ending opportunity to become a better person. And when you mess up (because trust me, you will), be kind to yourself. As I keep saying, humans are wonderfully imperfect. Even when we know what to do, sometimes we just don't or can't do it. ========== In this world of messy humans, how do you know who will be a good person for you to be with? My answer: Choose someone who wants to keep doing the work with you. There is no perfect person or partner for you, no magical human that won't ever hurt, irritate, enrage, or overwhelm you. Being in close relationships inevitably leads to big, scary feelings at times, so pick someone who wants to get through the dark times with you. Remember that when people are behaving badly in a desperate attempt to connect—not control—they'll be able to look at themselves, recognize the bad behavior, and change. Pick someone who has the willingness to self-reflect and grow, even if it's hard. Someone who will hang in there, even during your worst fights, and ultimately say, “Listen, this is awful, and I don't want to keep arguing like this, but I love you and I want to figure this out with you.” Wow. So well said. And this, in a paragraph, explains where Fatima and I failed. I dislike pointing fingers at my ex when explaining why we broke up. I made 90% of the mistakes in my relationship with Fatima, so I bear most of the responsibility. However, Fatima was the weaker one on one metric: having someone who wants to collaborate to make a beautiful relationship despite the hardships. The evident proof is that she dumped me five times, whereas I never dumped her or even threatened to dump her. I always wanted to use our problems as a chance to learn and improve. Fatima used them as an excuse to quit. She tried. She really did. However, she lacked the commitment Dr. Mosley discussed in that paragraph. Perhaps another man will inspire Fatima to find the strength and courage to bounce back and not throw in the towel. Or maybe she will mature and evolve to a point where she can be with someone less compatible than I was for her. She would often declare, “Francis, we're incompatible.” I'd say, “No, we are compatible; we have incompatibilities. Everyone has incompatibilities. We just need to work through them. If there is a willingness to collaborate, we can solve any incompatibility. The only couples who are truly incompatible are the ones where one or both individuals refuse to budge or learn. We can overcome countless incompatibilities as long as we both want to be together.” ========== We have wounds and scars and bad habits. We rely on ineffective but protective coping mechanisms. We push others away when we're hurt or scared. ========== Everyone behaves badly sometimes. But even then, odds are they're not gaslighting you. Conclusion I'll repeat: They're Not Gaslighting You: Ditch the Therapy Speak and Stop Hunting for Red Flags in Every Relationship is my favorite book in 2025! Buy it! Feedback Leave anonymous audio feedback at SpeakPipe More info You can post comments, ask questions, and sign up for my newsletter at http://wanderlearn.com. If you like this podcast, subscribe and share!  On social media, my username is always FTapon. Connect with me on: Facebook Twitter YouTube Instagram TikTok LinkedIn Pinterest Tumblr My Patrons sponsored this show! Claim your monthly reward by becoming a patron at http://Patreon.com/FTapon Rewards start at just $2/month! 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Le syndrome de dépersonnalisation est un trouble psychologique déroutant, souvent mal compris, dans lequel une personne a le sentiment d'être détachée de son propre corps ou de ses pensées. C'est comme si elle devenait spectatrice de sa propre vie, sans en être pleinement actrice. Ce phénomène peut être transitoire, mais lorsqu'il devient chronique, on parle alors de trouble de dépersonnalisation/déréalisation (selon la classification DSM-5).Des symptômes troublants mais non psychotiquesLes personnes touchées décrivent souvent une sensation d'irréalité. Elles peuvent dire qu'elles se sentent comme « en pilote automatique », qu'elles observent leur vie à travers une vitre, ou encore qu'elles ne se reconnaissent plus dans le miroir. Elles ont conscience que ces sensations sont subjectives et ne correspondent pas à une perte de contact avec la réalité, ce qui distingue ce syndrome des troubles psychotiques.La dépersonnalisation est souvent accompagnée de déréalisation : le monde extérieur paraît flou, étrange ou artificiel, comme dans un rêve. Les sons peuvent sembler étouffés, les couleurs altérées, et les interactions sociales deviennent difficiles à vivre car perçues comme irréelles.Un mécanisme de défense face à un stress extrêmeLa dépersonnalisation est généralement une réponse du cerveau à un stress psychologique intense. Elle agit comme un mécanisme de défense, une forme de "dissociation" qui permet à l'individu de se détacher temporairement de la douleur émotionnelle. Elle peut survenir après un traumatisme (accident, agression, deuil), mais aussi dans des contextes de stress chronique, de trouble anxieux ou de dépression.Certaines substances psychoactives (comme le cannabis, le LSD ou la kétamine) peuvent également déclencher des épisodes de dépersonnalisation, parfois prolongés.Prévalence et impactOn estime que plus de 50 % des personnes vivront un épisode bref de dépersonnalisation au cours de leur vie, mais seulement 1 à 2 % développeront un trouble persistant. Bien que non dangereux en soi, ce syndrome peut être très handicapant : il engendre souvent une grande détresse, un isolement social et une peur d'"être devenu fou".Des traitements possiblesIl n'existe pas de traitement unique, mais une approche combinée peut être efficace. Les thérapies cognitivo-comportementales (TCC) visent à réduire l'anxiété et à reconnecter la personne à ses sensations corporelles. Les techniques de pleine conscience et la thérapie d'acceptation et d'engagement (ACT) donnent également de bons résultats. En cas de comorbidité (comme une dépression ou un trouble panique), un traitement médicamenteux peut être prescrit.En somme, le syndrome de dépersonnalisation est une réaction de protection mal calibrée, mais il existe des solutions pour en sortir et retrouver le sentiment d'être pleinement soi-même. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

It's Mailbag Friday! You've got questions, we've got answers! Segment 1 • My son cut off all contact with our family over a year ago—what do I do when he won't speak to us? Segment 2 • Do prayers have to be spoken aloud—or does writing them count? • Horoscopes are vague—so how is the DSM-5 any more legitimate? • Is “once saved, always saved” biblical—or can you actually lose salvation? • Do all elders have to teach or preach—especially if they're unpaid? Segment 3 • Can a confessional Lutheran and a Reformed Baptist actually be friends? • Is it wrong to keep your eyes open during prayer? Asking for a friend. Segment 4 • Can I confront my dad's harsh treatment of my mom—or is that dishonoring him? • My “Christian” family excuses open sin—should I still attend gatherings? – Preorder the new book, Lies My Therapist Told Me, by Fortis Institute Fellow Dr. Greg Gifford now! https://www.harpercollins.com/pages/liesmytherapisttoldme – Thanks for listening! Wretched Radio would not be possible without the financial support of our Gospel Partners. If you would like to support Wretched Radio we would be extremely grateful. VISIT https://fortisinstitute.org/donate/ If you are already a Gospel Partner we couldn't be more thankful for you if we tried!

Episode 191: Diagnosis of ADHDFuture Dr. Granat explains how to diagnose Attention Deficit Hyperactivity Disorder. She explained the influence of social media in increasing awareness of ADHD. Dr. Arreaza added input about the validated tools for ADHD diagnosis and highlighted the importance of expert evaluation for the diagnosis of this disorder.  Written by Yen Stephanie Granat, MSIV. Ross University School of Medicine. Comments and editing by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Steph: I love podcasts—many of us do—and if you, like me, spend any amount of your leisure time listening to podcasts, perusing the news, or scrolling social media; you've likely noticed an alarming trend in the number of discussions we seem to be having about ADHD. It has grown into a very hot topic over the past couple of years, and for some of us, it seems to have even begun sneaking into our “recommended videos” and across our news feeds! Naturally, for the average person this can spur questions like:“Do I have ADHD? Do we all have it? How can I be certain either way, and what do I do if I find myself relating to most of the symptoms that I'm seeing discussed?”Granted that there is a whirlpool of information circulating around this hot topic, I was hoping to spend a bit of time clearly outlining the disorder for anyone finding themselves curious. I believe that can best be achieved through outlining a clear, concise, and easy-to-understand definition of what ADHD is; outlining what it is not; and helping people sift through the fact and the fiction. As with many important things we see discussed on the internet, we're seeing is that there is much more fiction than fact. Arreaza: I'm so glad you chose this topic! I think it is challenging to find reliable information about complex topics like ADHD. Tik Tok, Instagram and Facebook are great social media platforms, but we have to admit that fake news have spread like a fire in recent years. So, if you, listener, are looking for reliable information about ADHD, you are in the right place. With ADHD, there aren't any obvious indicators, or rapid tests someone can take at home to give themselves a reliable “yes” or “no” test result. People's concerns with ADHD are valid, and important to address, so we will discuss the steps to identify some of signs and symptoms they are seeing on TikTok or their favorite podcaster. Steph: Healthcare anxiety is a vital factor to consider when it comes to large cultural conversations around our minds and bodies; so, I hope to sweep away some of the misconceptions and misinformation floating around about ADHD. In doing so, I want to help alleviate any stress or confusion for anyone finding themselves wondering if ADHD is impacting their lives! We might even be able to more accurately navigate these kinds of “viral topics” (for lack of a better term) next time we see them popping up on our news feeds.Arreaza: The first thing I want to say about ADHD is “the crumpled paper sign.”Steph: What is that?Arreaza: It is an undescribed sign of ADHD, I have noticed it, and it is anecdotal, not evidence based. When I walk into a room to see a pediatric patient, I have noticed that when the paper that covers the examination table is crumpled, most of the times it is because the pediatric patient is very active. Then I proceed to ask questions about ADHD and I have been right many times about the diagnosis. So, just an anecdote, remember the crumpled paper sign.  Steph: When you have patients coming to you asking for stimulants because they think they have ADHD, hopefully, after today, you can be better prepared to help those patients. So, for the average person—anyone wanting to be sure if this diagnosis applies to them—how can we really know?”Arreaza: So, let's talk about diagnosis.Steph: Yes, the clearest information we have is the DSM-5, which defines these disorders, as well as outlines the specific criteria (or “checkpoints”) one needs to meet to be able to have a formal diagnosis. However, this manual is best utilized by a trained professional—in this case, a physician—who can properly assess your signs and symptoms and give you a clear answer. Steph: ADHD stands for Attention Deficit Hyperactivity Disorder. It is among the most common neurodevelopmental disorders of childhood. That is not to say it does not affect adult—it does—and because it can be easy to miss, it's very possible for someone to have ADHD without knowing. Arreaza: I recently learned that ADD is an outdated term. Some people with ADHD do not have hyperactivity but the term still applies to them. Steph: Yes, there are multiple types that I will explain in just a bit. But overall the disorder is most simply characterized by a significant degree of difficulty in paying attention, controlling impulsive behaviors, or in being overly active in a way that the individual finds very difficult to control. (CDC)Arreaza: How common is ADHD?Steph: The most recently published data from The CDC estimates that 7 million (11.4%) of U.S. children between the ages of 3 and 17 have been diagnosed with ADHD. For adults, it is estimated that there are 15.5 million (6%) individuals in the U.S. who currently have ADHD. Arreaza: I suspected it would be more than that. [Anecdote about Boy Scout camp]. Steph: I totally agree. With short videos on TikTok, or paying high subscription fees to skip ads, it feels like as a society we all have a shorter attention span. Arreaza: Even churches are adapting to the new generation of believers: Shorter sermons and shorter lessons.Steph: When it comes to better understanding these numbers, it's also important to know that there are three distinct presentations of ADHD recognized by The CDC and The World Health Organization. Arreaza: The DSM-5 TR no longer uses the word “subtypes” for ADHD. Instead, it uses the word "presentation" to describe the different ways that ADHD may manifest in a person. That reminded me to update my old DSM-5 manual and I ordered it while reading today about ADHD. This means people with ADHD are no longer diagnosed as having a “subtype”. Instead, they are diagnosed with ADHD and a certain “presentation” of symptoms.Steph: These presentations are:Inattentive TypePeople often have difficulty planning or completing tasksThey find themselves easily distracted (especially when it comes to longer, focus-oriented tasks)They can often forget details and specifics, even with things that are part of their daily routineThis used to be referred to as “ADD” (you'll notice the absence of an “H”, segue).Hyperactive-Impulsive TypePeople often have a sense of intense “restlessness”, noticeable even in calm environments.They tend to be noticeably more talkative, and might often be seen interrupting others, or finishing their sentences.They find significant difficulty in being still for extended periods. Because of this, they are often unable to sit through a movie or class time, without fidgeting or getting up and moving around.With this category of ADHD, we often see an impulsiveness that unwittingly leads to risky behavior. Because of this, accidents and bodily injury are more common in individuals with this type of ADHD.Combined TypeThese are individuals who exhibit symptoms from both “Inattentive” and “Hyperactive-Impulsive” ADHD equally.Some listeners might have noticed that the categories are quite different, meaning that ADHD presents in different ways depending on the person! Two people who have ADHD can be in the same room and have vastly different presentations, whilst still having many of the same types of challenges. You also might have noticed what makes the discussion so interesting to the general public, which is also the thing that makes speaking to a professional to get formally tested so important:The diagnostic criteria rely heavily on patterns of behavior, or external variables; rather than on how a person might feel, or certain measurements taken from lab tests.Arreaza: Diagnosing ADHD requires evaluation by a professional who is properly trained for this. Fortunately, we have tools to assist with the diagnosis. The attention deficit must be noted in more than one major setting (e.g., social, academic, or occupational), that's why the information should be gathered from multiple sources, including parents, teachers, and other caregivers, using validated tools, such as:The Neuropsychiatric EEG-Based ADHD Assessment Aid (NEBA), recommended by the American Academy of NeurologyThe Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS) and the Vanderbilt ADHD Diagnostic Teacher Rating Scale (VADTRS), recommended by the Society for Developmental and Behavioral Pediatrics.For adults: The validated rating scales include the Adult ADHD Self-Report Scale (ASRS) and the Conners Adult ADHD Rating Scales (CAARS).Steph: This is important because nearly everyone alive has experienced several, if not most, of these behavioral patterns at least once. Whether or not an individual has ADHD, I'm certain we could all think of moments we've had great difficulty focusing or sitting still. Perhaps some of us are incredibly forgetful, or act more impulsively than the average person might find typical. Getting a professional diagnosis is important because it is in skillfully assessing “the bigger picture” of a person's life, or their patterns of behavior, that a skilled physician, who understands the nuances and complexities in these disorders, can properly tell each of us whether we have ADHD, or not.Essentially, most of us could stand to use a bit more focus these days, but far fewer of us would meaningfully benefit from the kinds of treatments and therapies needed by individuals with ADHD to live healthier, more happy and regulated lives.Arreaza: I had a mother who came to discuss the results of the Vanderbilt Questionnaire. I think she left a little disappointed when she heard that, based on the responses from her and the teacher, her son did not have ADHD. Some kids may have behaviors such as being distracted during a meeting, forgetting about homework or having a lot of energy, but that does NOT mean necessarily that they have ADHD, right?Steph: Absolutely! The important thing to remember here is that these patterns of behavior outlined in the DSM-5 are merely an external gauge for a neurological reality. What the science is showing us is that the brains of people with ADHD are wired differently than that of the more “neurotypical” brain. Much like a check engine light would serve as a signal to a driver that something under the hood needs attention; these patterns of behavior, when they begin impeding our day to day lives, might tell us that it's time to see a professional (whether it be an auto mechanic or a trained physician). I think we all know someone who drives with their check engine light and not a care in the world. Arreaza: How serious/urgent is ADHD? Why should we care to make the diagnosis?Steph: Although we've yet to see anyone incur harm solely from having ADHD, it does lead to quite a range of more serious issues, some of which might prove more urgent. In the cases of ADHD, specifically, what we know is that there is a notable degree of dysregulation in some key neurotransmitters, like dopamine and norepinephrine. More plainly, what we are seeing in the brains of people with ADHD is a disruption, or alteration, of some of the brain's key chemicals.These neurotransmitters are largely responsible for much-needed processes like Motivation, Satisfaction, Focus, Impulse control, even things like energy and feelings of happiness. Many of these things serve as “fuel” for our day-to-day lives; things we'd call our “executive function”.  These are also what prove dysfunctional in those struggling with ADHD. It is in this sense that we might be able to bridge a meaningful gap between ADHD as being seen through patterns of behaviorthat signal a real, neurological reality.Steph: We often hear of the brain referenced as a kind of supercomputer. A more accurate assessment might be that the brain is more of a network of interconnected computers that run different processes and require continual communication with one another for our brain to function properly and seamlessly. What we're seeing in members of the population with this diagnosis, is a significant disruption in these lines of communication. Although this is a very broad oversimplification, for the purposes of our metaphor is to think of it like our brain chemicals getting caught in a traffic jam, or parts of our brain attempting to communicate to one another with poor cell signal. Arreaza: Making the diagnosis is critical to start treatment because having that level of dysfunction sounds like having a very difficult life.Steph: Yeah! I think that's why this conversation matters so much. There's a sense of urgency there, because much of life is, in fact, boring. Things like paying bills, exercising and eating well, work and school—these are all things that are vital to health and wellbeing in day-to-day life; and for the more neurotypical brain, these things might prove occasionally challenging. Yet, they are still doable. For those with ADHD however, this goes far beyond mere boredom or “laziness” (which proves to be a trigger term for many—more on that in just a bit).For folks listening, I wanted to offer some statistics that show why this is such a big concern for the public, whether one has a formal ADHD diagnosis or not. The facts are figures are:Children with ADHD are more than five times as likely as the child without ADHD to have major depression.A significant increase in the prevalence of anxiety is seen in ADHD patients, ranging from 15% to 35%, when accounting for overlap in symptoms.There are significant correlations in youth diagnosed with ADHD, and those diagnosed with what are known as “externalizing disorders”. These are things like Conduct Disorder, Disruptive Mood Dysregulation Disorder, and Oppositional Defiant Disorder.We are seeing a much higher rate of academic problems in kids who have ADHD, like reading disorder, impaired verbal skills, and visual motor integration.We're finding that many, if not most, of these connections are being made after diagnosis. In the case of the “internalized disorders”, like depression and anxiety, we're often seeing years between ADHD diagnoses and the diagnoses of major depressive disorder or anxiety disorders. Given this framework, much of the data is theorized to point towards what we call “negative environmental circumstances”, otherwise known as “ADHD-related demoralization”.For children, this often looks like struggling with sitting still during class, failing to get homework done (because they forgot, or couldn't focus on the tasks at hand), and struggling to focus their attention on what their teacher is saying during lecture. These things often lead to bad grades, discipline or forced time sitting still in detention. This can be seen in more problems at home, with children being disciplined often for behavior that they struggle immensely to control.For adults, this can mean forgetting to pay your bills, missing work meetings, having trouble making appointments, or having difficulty with day-to-day tasks, really anything that requires sustained attention. We often see adults with ADHD who are chasing normalcy with caffeine addictions or even struggling with substance use. Arreaza: Substance use disorder actually can be a way for some people living with ADHD to self-treat their symptoms. Steph: These differences between the individual's experience and the world around them can lead to really powerful feelings of failure or inadequacy. They can affect your social life, your sense of community, and even further limit your capacity to seek help.Literacy in these things is so important—not just for the individual who feels that they may have ADHD, but also for those who are likely to encounter people with ADHD in their own lives. Understanding why some of these patterns pop up, even those who might not have a formal diagnosis, can go a long way to properly approaching these behaviors with success and with empathy.Arreaza: Learning about ADHD is fundamental for primary care doctors. We talked about the high prevalence and the influence of the media in increasing awareness and sometimes increasing public panic. So, we have to be prepared to diagnose or undiagnosed ADHD. Steph: Whether we're the physicians in the room, or the patient in the chair, I think it's important to have a clear understanding of what ADHD is and how it can affect lives. Thanks for listening, I hope we were able to teach you a little more about ADHD. ______________Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _______________References:NICHQ-Vanderbilt-Assessment-Scales PDF: https://nichq.org/wp-content/uploads/2024/09/NICHQ-Vanderbilt-Assessment-Scales.pdfADHD: The facts. ADDA - Attention Deficit Disorder Association. (2023, January 11). https://add.org/adhd-facts/American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596.Gnanavel S, Sharma P, Kaushal P, Hussain S. Attention deficit hyperactivity disorder and comorbidity: A review of literature. World J Clin Cases. 2019 Sep 6;7(17):2420-2426. doi: 10.12998/wjcc.v7.i17.2420. PMID: 31559278; PMCID: PMC6745333.Staley BS, Robinson LR, Claussen AH, et al. Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment and Telehealth Use in Adults — National Center for Health Statistics Rapid Surveys System, United States, October – November 2023. CDC.Gov, MMWR Morb Mortal Wkly Rep 2024;73:890-895.Danielson ML, Claussen AH, Arifkhanova A, Gonzalez MG, Surman C. Who Provides Outpatient Clinical Care for Adults With ADHD? Analysis of Healthcare Claims by Types of Providers Among Private Insurance and Medicaid Enrollees, 2021. J Atten Disord. 2024 Jun;28(8):1225-1235. doi: 10.1177/10870547241238899. Epub 2024 Mar 18. PMID: 38500256; PMCID: PMC11108736. https://pubmed.ncbi.nlm.nih.gov/38500256/Mattingly G, Childress A. Clinical implications of attention-deficit/hyperactivity disorder in adults: what new data on diagnostic trends, treatment barriers, and telehealth utilization tell us. J Clin Psychiatry. 2024;85(4):24com15592. https://www.psychiatrist.com/jcp/implications-adult-adhd-diagnostic-trends-treatment-barriers-telehealth/Didier J. My four kids and I all have ADHD. We need telehealth options. STAT News. Published October 10, 2024. Accessed October 10, 2024. https://www.statnews.com/2024/10/10/adhd-medication-shortage-telehealth-dea-congress/.Hong J, Mattingly GW, Carbray JA, Cooper TV, Findling RL, Gignac M, Glaser PE, Lopez FA, Maletic V, McIntyre RS, Robb AS, Singh MK, Stein MA, Stahl SM. Expert consensus statement for telepsychiatry and attention-deficit hyperactivity disorder. CNS Spectr. 2024 May 20:1-12. doi: 10.1017/S1092852924000208. Epub ahead of print. PMID: 38764385. https://pubmed.ncbi.nlm.nih.gov/38764385/Gabor Maté: The Myth of Normal: Trauma, Illness, and Healing in a Toxic Culture. (2022). Youtube. Retrieved April 27, 2025, from https://www.youtube.com/watch?v=ttu21ViNiC0. Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

In this episode of CASAT Conversations, we are honored to welcome Dr. Steven C. Hayes, a pioneering clinical psychologist and the originator of Acceptance and Commitment Therapy (ACT). With decades of groundbreaking work that has transformed the field of psychotherapy, Dr. Hayes brings a deep understanding of how we build resilience, move through suffering, and live with purpose.Drawing from tribal traditions, spiritual wisdom, and cutting-edge behavioral science, Dr. Hayes shares how ACT helps people willingly take on their own history, turn toward their pain, and connect with what matters most. He reflects on pivotal moments in his career—including his TEDx Talk, Turning Pain into Purpose—and emphasizes the importance of developing mental flexibility in a post-COVID world where "5 out of 5 of us" need resilience.Dr. Hayes also critiques the systemic challenges facing the mental health field today, including the limitations of the DSM, the influence of pharmaceutical companies, and the reduction of individuals to data points in normative science. With humility and fierce compassion, he calls for a culture shift in psychotherapy—one where practitioners are empowered to trust their intuition, meet clients with curiosity, and reject categorical thinking in favor of wholeness and integration.In this episode, Dr. Hayes discusses:The role of acceptance in healing and transformationACT's connection to tribal traditions and human resilienceHow personal pain can become a path to purposeHis critique of the current mental health system and the DSMThe power of integrating all parts of ourselvesA vision for bottom-up change in psychotherapy through practitioner wisdomJoin us for a compelling and candid conversation about how we can reimagine mental health care—from the inside out—and reconnect with the core of what makes us human.Key words: acceptance and commitment therapy, ACT therapy, resilience, mental health, healing, wisdomResources: TEDTalk: https://www.youtube.com/watch?v=o79_gmO5ppgInstitute for Better health: https://www.ibh.com/Books by Steven C. Hayes, PhD

Since her first power sector job with Pacific Gas & Electric, Hannah Bascom knew she wanted to focus on people and clean energy — not on what she calls “the pipes and wires part of the business.”That interest led her to Nest in early 2014, just a few months after Google had acquired it. Almost a decade later, she moved on to SPAN and then Uplight, a technology partner for energy providers. Today, as Uplight's chief growth officer, Hannah thinks more than ever about how people interact with energy — and how to better manage that demand.This week on With Great Power, Hannah talks with Brad about the vital role of demand side management, also known as DSM, for managing load growth, and why she thinks leveraging the demand stack can help utilities to better manage that growth. They also discuss how Puget Sound Energy is using a VPP and rate program to reduce peak demand. And she talks about the important role that rate design can play in encouraging consumers to electrify their homes.With Great Power is a co-production of GridX and Latitude Studios.  Subscribe on Apple, Spotify, or anywhere you get podcasts. For more reporting on the companies featured in this podcast, subscribe to Latitude Media's newsletter.Credits: Hosted by Brad Langley. Produced by Erin Hardick and Mary Catherine O'Connor. Edited by Anne Bailey. Original music and engineering by Sean Marquand. Stephen Lacey is executive editor. The Grid X production team includes Jenni Barber, Samantha McCabe, and Brad Langley.

This week I'm talking with Dr. Maggie Sibley, a clinical psychologist and professor at the University of Washington School of Medicine. Dr. Sibley has spent over two decades studying ADHD, and is author or co-author of over 120 research papers on the topic. And she is the author of Parent-Teen Therapy for Executive Function Deficits and ADHD: Building Skills and Motivation. So recently, when I was working on the newsletter for the show, I came across an article about ADHD titled "Study describes fluctuations, remissions seen with ADHD,” and that felt like it was worth investigating more. While reading through the paper that was linked into the article I got to thinking, “hey, I'd love to ask some more questions about the findings in this paper,” and it occurred to me, hey, I can just reach out to the author of the paper for a conversation on the podcast. And so that's what today's show is all about, we dig into that paper, titled “Characteristics and Predictors of Fluctuating Attention-Deficit/Hyperactivity Disorder in the Multimodal Treatment of ADHD (MTA) Study” that looks into symptom fluctuation based on the a review of the Multimodal Treatment of ADHD (MTA) Study. We talk about how ADHD symptoms don't just disappear but actually tend to fluctuate — a lot more than many researchers expected. We also dive into why having more going on in life might actually make your ADHD symptoms less severe (or how that's just one interpretation of the results), how motivation works for us, and what it means to find your own “sweet spot” of structure. Plus, we get into the upcoming diagnostic guidelines for adult ADHD from the American Professional Society for ADHD and Related Disorders. This is definitely an episode you don't want to miss if you really enjoy the sciency side of things. Start Freedom today! Use code ADHD40 to get them 40% off a Freedom Yearly premium subscription! Listen to the Climbing the Walls podcast here! If you'd life to follow along on the show notes page you can find that at HackingYourADHD.com/222 YouTube Channel My Patreon This Episode's Top Tips ADHD symptoms don't always follow a straight decline or improvement. Symptoms can often fluctuate, sometimes improving for years and then intensifying again. Expect waves, not a straight line, and don't blame yourself when experiencing higher-than-normal symptoms. When you're in a phase where ADHD feels more manageable, that's a great time to try and take on more meaningful responsibilities — like work, school, or parenting — that can help create external structure and reinforce good patterns. While having more life demands (like a busy schedule, work responsibilities, or kids) can improve ADHD functioning by creating natural urgency and external motivators, it's also important to make sure it doesn't tip into overload. Not all clinicians are trained to recognize ADHD in adults, especially when childhood histories are murky. If your concerns are dismissed, it's okay — and important — to seek out a more knowledgeable provider. And on that note, look out for updated diagnostic and treatment guidelines for adult ADHD from APSARD (American Professional Society for ADHD and Related Disorders). While these guidelines won't change any of the diagnostic criteria in the DSM, they will help give clinicians clearer, evidence-based advice on how to apply them when evaluating ADHD in adults. 

Heath Lambert addresses questions about narcissism in Christian ministry: Is it widespread in churches, and should those displaying narcissistic traits be removed from leadership? Discover how Scripture reframes this contemporary psychological concern as the age-old spiritual problem of pride.TIMESTAMPS:0:00 Introduction to this week's topic on covert narcissism0:50 How the Marked by Grace question process works2:23 The two-part question: Is covert narcissism rampant in church? Should narcissists be fired?2:53 Understanding narcissism from a secular perspective4:11 The biblical equivalent: pride as described in Scripture5:13 Pride as the universal root problem of sinners6:31 Is narcissism (pride) rampant in the church?7:17 Should "covert narcissists" be fired from church positions?7:44 Biblical qualifications and 1 Timothy 3:6 on conceit8:56 The crucial distinction: struggling with pride vs. being "swollen with conceit"KEY POINTS:- Narcissism is a secular psychological term from the DSM describing traits like grandiosity, need for admiration, and arrogance- These characteristics closely align with what the Bible identifies as pride (1 John 2:16)- Pride—the desire to exalt ourselves above others and God—is the fundamental problem of every sinner- All Christians, including church leaders, struggle with pride in some form- The biblical qualification in 1 Timothy 3:6 isn't the absence of pride but not being "puffed up with conceit"- There's a significant difference between a qualified leader who battles pride and seeks to overcome it versus someone who is "swollen with conceit"- Disqualification should be based on biblical grounds (being dominated by pride), not merely secular psychological categories- Judgments about disqualification should come from those close to the person who observe a pattern, not from distant assumptionsSubmit your questions for future episodes to markedbyGrace@fbcjax.comSCRIPTURE REFERENCES:1 John 2:16 - "All that is in the world—the desires of the flesh and the desires of the eyes and the pride of life—is not from the Father but is from the world."1 Timothy 3:6 - "He must not be a recent convert, or he may become puffed up with conceit and fall into the condemnation of the devil."

******Support the channel******Patreon: https://www.patreon.com/thedissenterPayPal: paypal.me/thedissenterPayPal Subscription 3 Dollars: https://tinyurl.com/ybn6bg9lPayPal Subscription 5 Dollars: https://tinyurl.com/ycmr9gpzPayPal Subscription 10 Dollars: https://tinyurl.com/y9r3fc9mPayPal Subscription 20 Dollars: https://tinyurl.com/y95uvkao ******Follow me on******Website: https://www.thedissenter.net/The Dissenter Goodreads list: https://shorturl.at/7BMoBFacebook: https://www.facebook.com/thedissenteryt/Twitter: https://x.com/TheDissenterYT This show is sponsored by Enlites, Learning & Development done differently. Check the website here: http://enlites.com/ Dr. Robert Krueger is Distinguished McKnight University Professor in the Department of Psychology at the University of Minnesota. His specialties include behavior genetics, clinical and personality psychology, quantitative psychology, personality disorders, aging, and health. He is one of the most highly cited psychologists in the world. He is part ofthe leadership of an international project, The Hierarchical Taxonomy of Psychopathology (HiTOP), which aims to articulate a taxonomy of symptoms that provide researchers and practitioners with a means to describe an individual's mental health issues, as well as their major and minor symptoms, along a spectrum. In this episode, we start by talking about how psychiatric disorders are classified in the DSM and the ICD. We discuss what a mental disorder is, and the relationship between personality traits and psychopathology. We then talk about The Hierarchical Taxonomy of Psychopathology, the relationship between symptoms and traits, etiology and causal influences, and how disorders are classified within this framework. We also talk about a general factor of psychopathology, and personality disorders. Finally, we discuss subjective wellbeing, and how it relates to personality traits.--A HUGE THANK YOU TO MY PATRONS/SUPPORTERS: PER HELGE LARSEN, JERRY MULLER, BERNARDO SEIXAS, ADAM KESSEL, MATTHEW WHITINGBIRD, ARNAUD WOLFF, TIM HOLLOSY, HENRIK AHLENIUS, FILIP FORS CONNOLLY, ROBERT WINDHAGER, RUI INACIO, ZOOP, MARCO NEVES, COLIN HOLBROOK, PHIL KAVANAGH, SAMUEL ANDREEFF, FRANCIS FORDE, TIAGO NUNES, FERGAL CUSSEN, HAL HERZOG, NUNO MACHADO, JONATHAN LEIBRANT, JOÃO LINHARES, STANTON T, SAMUEL CORREA, ERIK HAINES, MARK SMITH, JOÃO EIRA, TOM HUMMEL, SARDUS FRANCE, DAVID SLOAN WILSON, YACILA DEZA-ARAUJO, ROMAIN ROCH, DIEGO LONDOÑO CORREA, YANICK PUNTER, CHARLOTTE BLEASE, NICOLE BARBARO, ADAM HUNT, PAWEL OSTASZEWSKI, NELLEKE BAK, GUY MADISON, GARY G HELLMANN, SAIMA AFZAL, ADRIAN JAEGGI, PAULO TOLENTINO, JOÃO BARBOSA, JULIAN PRICE, EDWARD HALL, HEDIN BRØNNER, DOUGLAS FRY, FRANCA BORTOLOTTI, GABRIEL PONS CORTÈS, URSULA LITZCKE, SCOTT, ZACHARY FISH, TIM DUFFY, SUNNY SMITH, JON WISMAN, WILLIAM BUCKNER, PAUL-GEORGE ARNAUD, LUKE GLOWACKI, GEORGIOS THEOPHANOUS, CHRIS WILLIAMSON, PETER WOLOSZYN, DAVID WILLIAMS, DIOGO COSTA, ALEX CHAU, AMAURI MARTÍNEZ, CORALIE CHEVALLIER, BANGALORE ATHEISTS, LARRY D. LEE JR., OLD HERRINGBONE, MICHAEL BAILEY, DAN SPERBER, ROBERT GRESSIS, JEFF MCMAHAN, JAKE ZUEHL, BARNABAS RADICS, MARK CAMPBELL, TOMAS DAUBNER, LUKE NISSEN, KIMBERLY JOHNSON, JESSICA NOWICKI, LINDA BRANDIN, GEORGE CHORIATIS, VALENTIN STEINMANN, ALEXANDER HUBBARD, BR, JONAS HERTNER, URSULA GOODENOUGH, DAVID PINSOF, SEAN NELSON, MIKE LAVIGNE, JOS KNECHT, LUCY, MANVIR SINGH, PETRA WEIMANN, CAROLA FEEST, MAURO JÚNIOR, 航 豊川, TONY BARRETT, NIKOLAI VISHNEVSKY, STEVEN GANGESTAD, TED FARRIS, AND ROBINROSWELL!A SPECIAL THANKS TO MY PRODUCERS, YZAR WEHBE, JIM FRANK, ŁUKASZ STAFINIAK, TOM VANEGDOM, BERNARD HUGUENEY, CURTIS DIXON, BENEDIKT MUELLER, THOMAS TRUMBLE, KATHRINE AND PATRICK TOBIN, JONCARLO MONTENEGRO, NICK GOLDEN, CHRISTINE GLASS, IGOR NIKIFOROVSKI, PER KRAULIS, AND BENJAMIN GELBART!AND TO MY EXECUTIVE PRODUCERS, MATTHEW LAVENDER, SERGIU CODREANU, ROSEY, AND GREGORY HASTINGS!

Want to improve your mental health? One of the easiest and most effective steps you can take is to foster to CONNECTION But to what? And how? In this episode, Dr. Adam Dorsay, author and host of the podcast Super Psyched, joins us for conversation about the intricacies of connection.What You'll Hear:Understanding ConnectionDr. Dorsay defines connection as "an internal emotional response that makes you feel alive" and reveals how disconnection appears in nearly every mental health diagnosis in the DSM. His framework identifies four essential types of connection: to Self, Others, the World, and Something Greater.Everyday DisconnectorsDiscover how our brain's preference for efficiency, constant device use, planning ahead, social comparison, and FOMO (Fear of Missing Out) prevent us from experiencing true connection and presence in our daily lives.The Nature ConnectionLearn about the restorative power of "forest bathing," how birdsong signals safety to our brains, and why time in nature visibly changes our appearance and emotional state.About Dr. Adam Dorsay:Dr. Adam Dorsay is a licensed psychologist, speaker, and author of "Super Psyched: Unleash the Power of the Four Types of Connection and Live the Life You Love." With over 20,000 hours of psychotherapy experience, Dr. Dorsay has developed a unique framework for understanding how connection impacts mental health and overall wellbeing. His approach combines clinical experience with practical wisdom to help people live more fully and authentically.Resources:Book: "Super Psyched: Unleash the Power of the Four Types of Connection and Live the Life You Love"Podcast: Super Psyched with Dr. Adam DorsaySign up for my newsletter at https://merylarnett.substack.com/ to receive free mini meditations and soundscapes each week, along with creative musings and more.New episodes every Monday (just the meditation) and Thursday (a full meditation class).Learn more or contact me at https://www.merylarnett.com/. Thank you to Nick McMahan for today's editing; and thank you to Brianna Nielsen for production and editing support. Find them at:https://www.nickcmcmahan.comhttps://www.instagram.com/briannanielsen_marketingThis podcast explores meditation, mental health and the power of connection, offering guidance for caregivers, healers, and therapists facing compassion fatigue, burnout, and other mental health struggles through self-care, self-compassion, and resilience. With a focus on anxiety, depression, and overwhelm, each episode provides tools like meditation, mindfulness, breathwork, and grounding to cultivate clarity and reduce stress. Listeners can also experience nature-inspired guided meditations, designed to bring peace and balance in times of distress.

In this episode, Elle and Vee chat with Priestess Francesca about kink, piss, and the juicy world of dark desires. Bring your curiosity and leave your shame at the door.What is Dark Erotiscm? (3:04)Shadow Work: “fill the hole where shame used to be with love and acceptance.” (10:09)Taboo Kinks: Why are we afraid of our kinks and how can we approach them? (13:57)How can you start exploring your dark erotic desires? What to check for before you begin on your kink journey. (17:58)Where do turn-ons come from? The psychology behind why we desire what we do. The eroticsm of our traumatic experiences: recreate or obliterate. (23:40)Vee's first erotic piss play scene! (28:55)Unpacking Pee Play: How do you find where the pleasure lies? (34:52)Solo Piss Play: drinking your own golden nectar. (39:49)How to spin toilet play differently depending on the energy of the scene (worship, degradation, objectification). (40:56)Psychology behind degradation play, and the power behind Priestess Francesca's Scat Play Scene. (43:09)Discomfort is not always productive: growth vs guardianship of yourself. (48:26)Freak School. (55:09)Erotic Alchemy. (56:34)Priestess Francesca Links:WebsiteInstagramFree Masterclass!Source Information: Homosexuality in the DSM: While homosexuality was formally removed from the Diagnostic and Statistical Manual (DSM) of Mental Disorders in 1973, it wasn't until DSM-5 (which mobilized it's task force of 13 work groups in 2007 to focus on various disorder areas) that all diagnostic categories pertaining to sexual orientation were removed.  Many scholars and advocacy groups believe that only this can be considered "complete declassification" of non-heterosexual sexual orientations as mental disorders.BDSM in the DSM: Thanks to tremendous efforts by the National Coalition for Sexual Freedom (NCSF) the American Psychiatric Association (APA) announced in 2010 that it would be changing the diagnostic codes for BDSM in the next edition of the DSM (formally published in 2013 and integrated into practice in the years that followed). Trans Porn Statistical Analysis by State (USA): In 2022, Lawsuit.org issued statistical analysis to understand the love for transgender related porn by scraping daily Google search trend data, segmenting by DMA (metro area), and comparing search volume to both 2020 election voting trends, and public opinions about LGBT rights. "The data tells a tragic tale of self-loathing closet cases, Republicans who privately get off sexually to trans folks, while publicly trying to remove trans peoples' rights and stoking hate against them." You can dig into their data analysis and conclusions here Where to find us, and how you can support us:Instagram: @girlsgonedeeppod Merch: girlsgonedeep.com/shop Woo More Play Affiliate Link: Support us while you shop! WHOREible Life: Get 10% off your deck with code GONEDEEP at whoreiblelife.com Instagram: @wlthegameContact: girlsgonedeep@gmail.com

Segment 1 • Contemporary worship on YouTube is flooded with emotionally charged, man-centered music that feels more exhausting than edifying. • Much of today's worship music centers on emotionalism, not exalting Christ. • When you hear biblically rich, Christ-centered lyrics like “The King in All His Beauty,” it's clear—true worship exalts Jesus, not emotion, experience, or self. Segment 2 • Churches are increasingly turning to recycled pop songs and rebranding them as worship music, blurring the lines between sacred and secular. • The Catholic Church prepares for its next conclave this week which will select the new Pope. • The bizarre tradition of showcasing the literal hearts of former popes—raising questions about relic worship and pagan parallels. Segment 3 • “Side B Christianity,” which affirms same-sex attraction as identity but forbids action, is gaining ground in some corners of the PCA. • The PCUSA has already shifted further, redefining missions as “whatever God is doing” and eliminating its missionary department entirely. • Why our identity must be found in Christ, not our sinful proclivities. Segment 4 • Odd stories from around the world–”Florida ants are the only animals besides humans that perform surgery.” • Alpharetta Bible Church's gospel-centered mission serves as a touchstone amid cultural confusion. • Despite rising pornography use, the DSM-5 still contains no diagnostic category for it—underscoring how secular frameworks often ignore deep spiritual issues. – Preorder the new book, Lies My Therapist Told Me, by Fortis Institute Fellow Dr. Greg Gifford now! https://www.harpercollins.com/pages/liesmytherapisttoldme – Thanks for listening! Wretched Radio would not be possible without the financial support of our Gospel Partners. If you would like to support Wretched Radio we would be extremely grateful. VISIT https://fortisinstitute.org/donate/ If you are already a Gospel Partner we couldn't be more thankful for you if we tried!

Is Trump Derangement Syndrome a legitimate mental health disorder? Dr. Carole Lieberman thinks so - she's even trying to get it accepted into the DSM. She's internationally renowned as “The Terrorist Therapist,” a board certified psychiatrist, 3-time Emmy honored TV personality, radio talk show host, best-selling author and professional speaker. Stay tuned and learn about the symptoms of Trump Derangement Syndrome, why people have it, and why Trump triggers people like no other individual in American history. Chapters: Intro | 0:00 - 02:25What is Trump Derangement Syndrome? | 02:25 - 04:37 Will someone with TDS seek out a psychiatrist? | 04:37 - 05:37 What's the response from other psychiatrists regarding TDS? | 05:37 - 10:18What is it about Trump that triggers people? | 10:18 - 14:50Does TDS manifest differently according to age? | 14:50 - 15:26Do those with TDS have underlying trauma or mental health issues? |15:26 - 16:31 Do MAGA women love Trump because he's a bad boy? 16:31 - 17:24What's the spectrum of TDS symptoms? | 17:24 - 25:28How dangerous is someone with TDS? | 25:28 - 29:00What percent of the left has TDS? | 29:00 - 29:19 Will TDS disappear after Trump leaves office? | 29:19 - 30:19Are there other psychological disorders centered around one person? | 30:19 - 33:31Would TDS exist without social media? | 33:31 - 35:08 Is TDS a cheap trick to discount Democrats and progressives? | 35:08 - 38:13 Does the right have their own derangement syndrome? | 38:13 - 41:13 Is there a distinction between Tesla protests and January 6? | 41:13 - 43:51Is MAGA a cult? | 43:51 - 46:00 What's the psychological profile of Epstein and his followers? | 46:00 - 55:41 Where to find Dr. Carole Lieberman online? 54:41- *** Follow Dr. Carole Lieberman on social media! Twitter | https://x.com/DrCaroleMD Facebook | https://www.facebook.com/CaroleLiebermanMD Websites | https://expertwitnessforensicpsychiatrist.com/ http://www.drcarole.com/ https://terroristtherapist.com/ Phone: 310-278-5433 Email: drcarole@earthlink.net***You can check out Ladies Love Politics website to read a transcript/references of this episode at www.ladieslovepolitics.com. Be sure to follow the Ladies Love Politics channel on TikTok, Instagram, YouTube, Truth Social, Brighteon Social, Threads, and Twitter. Content also available on Apple Podcasts, Google Podcasts, Spotify, and wherever else you stream podcasts. Background Music Credit:Music: Hang for Days - Silent Partner https://youtu.be/A41A0XeU2ds

What happens when two global biotech giants team up to tackle one of aquaculture's biggest bottlenecks? You get Veramaris - a joint venture between DSM and Evonik that's producing high-potency omega-3s from algae, not fish.In this episode, Tony sits down with Ian Carr and Yann Le Gal from Veramaris to unpack how industrial-scale fermentation could be the key to unlocking more predictable, scalable, and sustainable feed nutrition for the seafood industry.We dive into:Why the supply of EPA and DHA is critical - and maxed out from traditional sourcesHow algae oil offers pricing stability in a volatile marketWhat it took to scale a fermentation plant in NebraskaAnd what new big data from Manolin reveals about omega-3 nutrition and farm performance at scaleWhether you're a feed miller, farmer, investor, or just trying to make sense of the evolving aquafeed landscape, this is an episode packed with insights on innovation, sustainability, and the future of aquaculture.

Send us a textStruggling to master personality disorders for your upcoming licensure exam? Look no further than this deep dive into Dependent Personality Disorder (DPD) – a condition you might encounter on test day.We meticulously break down the DSM diagnostic criteria, requiring at least five symptoms from a pattern that includes difficulty making everyday decisions, needing others to assume responsibility for major life areas, and fears of being left to care for oneself. You'll learn to recognize the classic clinical presentation: clients who consistently defer to others, express intense abandonment fears, and often tolerate mistreatment rather than risk being alone. Most importantly, we clarify how to differentiate DPD from its common look-alikes like Borderline, Avoidant, and Histrionic Personality Disorders –  distinctions that frequently appear as exam questions.The episode explores DPD's developmental trajectory, typically rooted in childhood experiences with overprotective or authoritarian parenting that restricted age-appropriate autonomy. We examine how cultural factors influence diagnosis and discuss common comorbidities including anxiety disorders, depression, and substance use. The second half provides a comprehensive review of evidence-based treatments, from cognitive-behavioral approaches that challenge core beliefs about helplessness to schema therapy addressing early maladaptive patterns. You'll learn specific interventions like gradual exposure to independent decision-making, assertiveness training, and anxiety management techniques.Whether you're preparing for your exam or working with dependent clients in clinical practice, this episode delivers everything you need to understand this complex condition. Subscribe to Demystifying Disorders for more exam-focused breakdowns of essential mental health topics, and leave us a review if you found this helpful for your exam prep!If you need to study for your national licensing exam, try the free samplers at: LicensureExamsThis podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.

Pica in children with autism, touching on its link to PANS, nutritional deficiencies, emotional factors, and gut health. Pica is a complex and often misunderstood condition that can be particularly concerning when observed in children with autism. It involves the persistent eating of non-food items such as dirt, paper, chalk, hair, or even small objects like coins or toys. While pica can occur in children of all backgrounds, it is significantly more common in individuals with autism spectrum disorder (ASD). Understanding the why behind this behavior is crucial for parents, caregivers, and professionals who want to provide appropriate support. What Is Pica? Pica is defined by the DSM-5 as the repeated ingestion of non-nutritive substances over a period of at least one month, and at an age where this behavior is developmentally inappropriate. In children with autism, pica can often persist beyond toddler years and may require clinical attention due to the risks involved, including choking, intestinal blockages, poisoning, and exposure to harmful bacteria. Why Is Pica More Common in Children with Autism? There are multiple factors that can contribute to pica behaviors in children with autism, including sensory processing differences, emotional regulation difficulties, nutritional deficiencies, and underlying medical conditions. Here are some key contributors: 1.  Nutritional and Mineral Deficiencies One of the most common underlying causes of pica is a deficiency in essential nutrients and minerals. When the body lacks certain elements, it may instinctively seek out non-food items that contain trace amounts of what it's missing. In children with autism, this is especially relevant due to dietary restrictions, picky eating, or poor absorption caused by gut health issues. Common deficiencies linked to pica include: Iron – Low iron levels (anemia) have a strong correlation with pica. Increasing heem foods which are rich in iron are suggested. Thai is much better than supplementing with iron since iron supplements can aggravate virus activity. Food-based supplements are a much safer way to increase iron naturally.   Zinc – Important for taste, smell, and immune function.  Magnesium – Needed for neurological and muscular function.  Calcium – Can influence cravings for chalk or dirt.  Vitamin D and B12 – Deficiencies can affect mood, energy, and neurological health.  Children with autism may be more susceptible to these deficiencies due to selective eating, inflammation, or gut dysbiosis. 2.  Emotional and Sensory Reasons Pica can also be a self-soothing or sensory-seeking behavior. Children with autism may have heightened or lowered sensory sensitivities and may find certain textures, smells, or even the act of chewing or swallowing non-food items calming or stimulating. Other emotional and psychological factors that may drive pica include: Stress or anxiety – Non-food chewing may become a coping mechanism.  Communication challenges – Inability to express discomfort or emotional needs might manifest as pica.  Obsessive-compulsive tendencies – Some children may develop ritualistic eating of non-foods.  Providing alternative sensory activities and emotional regulation tools can help reduce the compulsion. 3.  Pica as a Symptom of PANS (Pediatric Acute-onset Neuropsychiatric Syndrome) PANS is a neuroimmune condition characterized by the sudden onset of obsessive-compulsive symptoms, eating restrictions, tics, or emotional disturbances following infection or inflammation. Interestingly, pica has been observed in children experiencing flare-ups of PANS, particularly when inflammation in the brain affects areas related to impulse control and appetite. In these cases, pica may appear suddenly and be accompanied by other neuropsychiatric symptoms. If this is suspected, seeking a qualified PANS/PANDAS specialist is critical, as treatment often involves addressing underlying infections and modulating the immune response... Click Here or Click the link below for more details! https://naturallyrecoveringautism.com/219

Our brain and nervous systems are incredibly protective—they can shield us from overwhelming stimuli by shutting out sensations. This mechanism plays a central role in depersonalization and derealization (DPDR), causing you to feel detached and like you are observing yourself from a distance. While these dissociative states can offer short-term protection, chronic experiences can lead to further dysregulation as unprocessed emotions accumulate. In today's episode, Elisabeth and Jennifer dive into DPDR, explaining its impact on the brain and nervous system. They discuss why our senses become muted, its protective role, and how it shows up in those with childhood trauma. Elisabeth and Jennifer also share their personal experiences and how they found safety in their bodies to process their emotions. While our brain and body protect us from overwhelming sensations, the stored experience remains within us. The journey to healing involves convincing our brain and body that it's safe to reconnect with these feelings, building internal capacity to do so. Simply understanding DPDR isn't enough; we must communicate with our nervous system to reclaim our sense of self. If you've experienced depersonalization and derealization and are seeking healing insights, don't miss this episode! Topics discussed in this episode: What is depersonalization and derealization (DPDR)? Why are our senses muted, yet still active, during DPDR? The connection between CPTSD and DPDR The high levels of dysregulation that occur with DPDR Co-regulation versus nervous system disconnection How derealization and depersonalization function as adaptive strategies Why healing DPDR requires working directly with the nervous system What happens when you finally start feeling again after DPDR How to cultivate a sense of safety around your internal signals The vagus nerve's role in healing DPDR and practical techniques to activate it Get started training your nervous system with our FREE 2-week offer on the Brain Based Membership site: https://www.rewiretrial.com   Connect with us on social media: @trauma.rewired   Join the Trauma Rewired Facebook Group! https://www.facebook.com/groups/761101225132846   FREE 1 Year Supply of Vitamin D + 5 Travel Packs from Athletic Greens when you use my exclusive offer: https://www.drinkag1.com/rewired   This episode was produced by Podcast Boutique https://www.podcastboutique.com Trauma Rewired podcast  is intended to educate and inform but does not constitute medical, psychological or other professional advice or services. Always consult a qualified medical professional about your specific circumstances before making any decisions based on what you hear.  We share our experiences, explore trauma, physical reactions, mental health and disease. If you become distressed by our content, please stop listening and seek professional support when needed. Do not continue to listen if the conversations are having a negative impact on your health and well-being.  If you or someone you know is struggling with their mental health, or in mental health crisis and you are in the United States you can 988 Suicide and Crisis Lifeline.  If someone's life is in danger, immediately call 911.  We do our best to stay current in research, but older episodes are always available.  We don't warrant or guarantee that this podcast contains complete, accurate or up-to-date information. It's very important to talk to a medical professional about your individual needs, as we aren't responsible for any actions you take based on the information you hear in this podcast. We  invite guests onto the podcast. Please note that we don't verify the accuracy of their statements. Our organization does not endorse third-party content and the views of our guests do not necessarily represent the views of our organization. We talk about general neuro-science and nervous system health, but you are unique. These are conversations for a wide audience. They are general recommendations and you are always advised to seek personal care for your unique outputs, trauma and needs.  We are not doctors or licensed medical professionals. We are certified neuro-somatic practitioners and nervous system health/embodiment coaches. We are not your doctor or medical professional and do not know you and your unique nervous system. This podcast is not a replacement for working with a professional. The BrainBased.com site and Rewiretrail.com is a membership site for general nervous system health, somatic processing and stress processing. It is not a substitute for medical care or the appropriate solution for anyone in mental health crisis.  Any examples mentioned in this podcast are for illustration purposes only. If they are based on real events, names have been changed to protect the identities of those involved.  We've done our best to ensure our podcast respects the intellectual property rights of others, however if you have an issue with our content, please let us know by emailing us at traumarewired@gmail.com  All rights in our content are reserved  

Are You Joyful… or Just Functioning? Most people don't realize it—but there's a silent struggle happening behind the smiles and the schedules. Today, I sit down with Dr. Judith Joseph, a Columbia-trained psychiatrist and author of High Functioning: Overcome Your Hidden Depression and Reclaim Your Joy. We tackle something that I think is affecting more people than anyone talks about… high functioning depression. It's not in the "DSM"—but it's very real. And if you've ever felt like you're doing everything “right” but still feel empty inside, you need to hear this. We talked about a condition called anhedonia—this sneaky, silent twin of depression that robs you of joy without making you collapse. It's the part of depression that doesn't get seen or treated because you're still performing, still producing, still achieving. Dr. Judith broke down how traumas, even the little ones, can rewire the way we experience joy. And more importantly, she gave a way out. You don't have to crash to get help. You don't have to be broken to deserve healing. This episode isn't just about naming the problem. It's about owning your emotional truth, slowing down, and reclaiming the simple human experiences that actually fill you. Whether you're a high achiever constantly “doing” or someone who feels like joy is always out of reach, this one's for you. Judith's “5 V's” framework gives you real tools you can use every day—like planning your joy, validating your feelings, and choosing presence over performance. And let me tell you what stood out most. Joy is contagious! It spreads. To your kids, your spouse, your team. The more we access joy, the more we model it for those around us. This conversation hit home for me—and I think it will for you too. Key Takeaways: Why anhedonia is the overlooked symptom stealing your joy. The difference between happiness (an idea) and joy (an experience). The “5 V's” system to help reclaim joy: Validation, Venting, Values, Vitals, Vision. How trauma—big or small—can lead to high functioning depression. Tools to help yourself or someone you love who's silently struggling. The impact of hormonal changes on mental health, especially for women. A method to ground yourself daily and reduce anxiety: the 5-4-3-2-1 technique. Let's not wait for the crash to start healing. You deserve joy. You just forgot how to feel it. Max out.

Send us a textPanic disorder remains one of the most frequently misunderstood anxiety conditions in clinical practice and on licensing exams. We dive deep into what makes this disorder truly distinct from general anxiety - the sudden, intense nature of panic attacks compared to anxiety's gradual build.For therapists and students preparing for licensing exams, understanding the three types of panic attacks is crucial. Unexpected attacks strike without warning, situationally bound attacks consistently occur in specific contexts, and situationally predisposed attacks may or may not occur upon exposure to triggers. This unpredictability creates elaborate avoidance strategies that significantly impact clients' quality of life.The DSM diagnostic criteria requires recurrent unexpected panic attacks followed by at least one month of persistent concern or behavioral changes, with four or more specific symptoms during attacks. At the core of this disorder lies what we call the "fear response cascade" - a self-perpetuating cycle where bodily sensations are catastrophically misinterpreted, triggering more anxiety and physical symptoms.We explore essential assessment tools like the Panic Disorder Severity Scale and the Anxiety Sensitivity Index, which help clinicians track symptoms and guide treatment. Effective approaches combine psychoeducation, cognitive restructuring, and breathing techniques, progressing to interoceptive exposure and in vivo desensitization.Common challenges in treatment include clients' reluctance to abandon safety behaviors and patterns of medical reassurance seeking. Whether you're studying for exams or working with clients experiencing panic, this episode provides clear, practical guidance for understanding and treating this complex condition. Subscribe for more clinical insights and exam preparation tips!If you need to study for your national licensing exam, try the free samplers at: LicensureExamsThis podcast is not associated with the NBCC, AMFTRB, ASW, ANCC, NASP, NAADAC, CCMC, NCPG, CRCC, or any state or governmental agency responsible for licensure.

Did you know that Borderline Personality Disorder (BPD) wasn't "discovered" but actually created? A group of male psychiatrists voted to define it as a diagnosis, and women, in particular, are disproportionately labeled with it, and it's often weaponized against them. What if we told you that BPD isn't a disorder at all, but rather a logical and rational response to repressed emotions and shame caused by trauma, whether systemic or sexual? This is exactly what we're unpacking in today's episode. Join Elisabeth and Jennifer as they welcome Mollie Adler, podcaster, writer, and existential thinker, to dive deep into the issues surrounding the BPD diagnosis. Together, they discuss the stigma around BPD, the trauma as a potential cause, and how repressed emotions and shame fuel the symptoms. Also, Mollie shares her own experience of seeking a diagnosis, and why she didn't receive one. What we explore in this episode is eye-opening: BPD is not a disorder, but a survival mechanism from unresolved trauma, one that can be healed by working to create safety in the nervous system and getting to the root cause. If this resonates with you, don't miss out—tune in to learn more and discover how healing is possible. Topics discussed in this episode: Mollie Adler's personal journey with BPD The problems with the current diagnostic framework The stigma surrounding personality disorders How BPD characteristics contribute to long-term emotional and interpersonal instability The systemic trauma linked to BPD Understanding the inputs that create the output, and how to create change with BPD The impact of sexual trauma and fawning in women with BPD The history and legacy of hysteria The power of releasing repressed emotions and toxic shame to heal The privilege of reclaiming your BPD diagnosis What it means to disidentify from your diagnosis Connect with Mollie Adler by heading to her Instagram page here: https://www.instagram.com/backfromtheborderline/?hl=en Find Molly's podcast Back from the Borderline on all platforms that host podcasts.    Learn more about the Neuro-Somatic Intelligence Coaching program and sign up for the next cohort now! https://www.neurosomaticintelligence.com   Get started training your nervous system with our FREE 2-week offer on the Brain Based Membership site: https://www.rewiretrial.com   Connect with us on social media: @trauma.rewired   Join the Trauma Rewired Facebook Group! https://www.facebook.com/groups/761101225132846   FREE 1 Year Supply of Vitamin D + 5 Travel Packs from Athletic Greens when you use my exclusive offer: https://www.drinkag1.com/rewired   This episode was produced by Podcast Boutique https://www.podcastboutique.com Trauma Rewired podcast  is intended to educate and inform but does not constitute medical, psychological or other professional advice or services. Always consult a qualified medical professional about your specific circumstances before making any decisions based on what you hear.  We share our experiences, explore trauma, physical reactions, mental health and disease. If you become distressed by our content, please stop listening and seek professional support when needed. Do not continue to listen if the conversations are having a negative impact on your health and well-being.  If you or someone you know is struggling with their mental health, or in mental health crisis and you are in the United States you can 988 Suicide and Crisis Lifeline.  If someone's life is in danger, immediately call 911.  We do our best to stay current in research, but older episodes are always available.  We don't warrant or guarantee that this podcast contains complete, accurate or up-to-date information. It's very important to talk to a medical professional about your individual needs, as we aren't responsible for any actions you take based on the information you hear in this podcast. We  invite guests onto the podcast. Please note that we don't verify the accuracy of their statements. Our organization does not endorse third-party content and the views of our guests do not necessarily represent the views of our organization. We talk about general neuro-science and nervous system health, but you are unique. These are conversations for a wide audience. They are general recommendations and you are always advised to seek personal care for your unique outputs, trauma and needs.  We are not doctors or licensed medical professionals. We are certified neuro-somatic practitioners and nervous system health/embodiment coaches. We are not your doctor or medical professional and do not know you and your unique nervous system. This podcast is not a replacement for working with a professional. The BrainBased.com site and Rewiretrail.com is a membership site for general nervous system health, somatic processing and stress processing. It is not a substitute for medical care or the appropriate solution for anyone in mental health crisis.  Any examples mentioned in this podcast are for illustration purposes only. If they are based on real events, names have been changed to protect the identities of those involved.  We've done our best to ensure our podcast respects the intellectual property rights of others, however if you have an issue with our content, please let us know by emailing us at traumarewired@gmail.com  All rights in our content are reserved  

In this conversation, Dr. Rob Weiss discusses the complexities of sex and porn addiction, emphasizing the lack of formal recognition in diagnostic manuals like the DSM-5. He explores the distinction between compulsion and addiction, the societal stigma surrounding these issues, and the importance of understanding the underlying behaviors that lead to relationship problems. The conversation highlights the critical role of trust in relationships and the impact of secrecy on intimacy, as well as practical steps for individuals seeking help.   Connect with Dr. Rob Weiss Find Out More About My DeepClean Recovery Program Here Get A Free Copy of The Last Relapse, A Blueprint For Recovery Watch Sathiya on Youtube For More Content Like This   Chapters 00:00 Understanding Sex and Porn Addiction 13:01 Defining Compulsion vs. Addiction 25:50 The Impact of Secrecy and Trust in Relationships 29:58 Understanding the Impact of Betrayal 34:57 Rebuilding Trust and Intimacy 39:56 Developing Empathy in Recovery 44:34 The Connection Between Addiction and Narcissism 50:05 Pro-Dependence vs. Codependency 58:45 Defining Recovery and Its Challenges