Podcasts about DSM

Actor Peter Dinklage and playwright Erica Schmidt have been married for two decades, and even though they've collaborated on projects, it's rare for them to do an interview together. That's why we were so excited when they agreed to join Anna on stage at the Tribeca Festival to discuss how they balance privacy and family, why they wish interviewers would stop fixating on Game of Thrones, and how they met on a romantic evening when elephants walked through Manhattan. This episode was produced by Cameron Drews. Extra thanks to Alexandra Cohl and Katie Rayford, who helped with the live event, and Davy Gardner and Allyson Morgan, our talented friends at the Tribeca Festival. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

Does this sound familiar?“I'm busy all day, but I don't get anything done. I want something to show for my efforts.”“Everyone in my life is tired of my lateness and unreliability.”“I can't get motivated unless I'm facing a deadline, and what I produce isn't as good as it could be.”In this episode of A Mind of Her Own with Jennifer Reid, MD, we hear from adult ADHD expert, J. Russell Ramsay, PhD about a new way of viewing ADHD: as fundamentally a self-regulation problem, not an attention problem. The name is misleading. What's really impaired is the ability to organize behavior across time in order to consistently follow through on what you intend to do.CBT adapted for ADHD works differently than standard CBT. The focus isn't on changing negative thoughts. It's on reverse-engineering the how of not doing things, then building explicit step-by-step plans. The goal is slowing down the executive function deliberately, making implicit steps external and visible.The Core Executive Functions Affected in ADHD:* Inhibition (pausing before responding automatically)* Nonverbal working memory (mental simulation and planning)* Verbal working memory (internal self-talk and staying on track)* Emotional regulation and motivation (generating drive in the absence of immediate consequences)* Reconstitution (flexible, creative problem-solving)Emotional dysregulation is a core feature, but it's invisible in the DSM. Emotions don't appear in the diagnostic criteria at all, yet they drive much of what people actually struggle with: impulsive reactions, difficulty tolerating discomfort, and using guilt as a misguided motivator.Women are significantly under-diagnosed and diagnosed later. CDC data from 2024 found that 50% of people with ADHD were diagnosed at age 18 or older, and 61% of those were women. Girls' symptoms often appear on the playground rather than in the classroom, with social disruption rather than academic chaos, making them easier to overlook. Women are also more likely to be diagnosed first with anxiety or depression.Self-mistrust is a hallmark and often mistaken for low confidence. After years of inconsistent follow-through, many adults with ADHD stop trusting themselves to do what they set out to do. This isn't simply low self-esteem; it's a learned pattern of doubting one's own reliability, often amplified by the unspoken message: it must be something I'm doing wrong.High functioning doesn't mean unaffected. Many people mask symptoms for years through compensatory strategies: all-nighters, parental scaffolding, sheer willpower, until the scaffolding is removed or life demands multiply (new job, parenthood, caregiving, perimenopause).Front-end perfectionism drives procrastination. The biggest cognitive distortion in ADHD isn't negativity, it's the belief that conditions must be perfect before starting. Waiting to feel focused, energized, or “in the mood” guarantees perpetual delay. The reframe: Do I have enough to begin?ADHD also brings real strengths. Creativity, the ability to hyper-focus in stimulating environments, hands-on intuitive knowledge, persistence when engaged, and the capacity for innovative thinking are all genuine advantages, not consolation prizes.Resources Mentioned* Book: Once I Get Started: The Adult ADHD Program for Turning Your Intentions into Actions — Dr. Russell Ramsay (Avery/Penguin Random House, May 2025)* Book: You Mean I'm Not Lazy, Stupid or Crazy?! — Kate Kelly & Peggy Ramundo (mid-90s classic, still widely cited)* Book: The Power of Habit — Charles Duhigg (source of the “keystone habit” concept)* Book: The Extended Mind: The Power of Thinking Outside the Brain — Annie Murphy Paul (on environment, cognition, and the need for solitude)* Book: Living Well with Adult ADHD: Practical Strategies for Improving Your Daily Life — Dr. Laura Knouse & Dr. Russell Barkley (Guilford Press, 2025)* Researcher: Dr. Margaret Sibley — Professor of Psychiatry & Behavioral Sciences, University of Washington; leading work on adult ADHD diagnosis guidelines through the American Professional Society of ADHD and Related Disorders (APSARD)* Researcher: Dr. Russ Barkley — foundational work on ADHD as executive dysfunction* Assessment tool: QB Test (Qbtech) — computerized continuous performance task used to objectively measure attention, impulsivity, and activity* Website: cbt4adhd.com — Dr. Ramsay's practice, contact form, and resourcesAbout Dr. Russell RamsayDr. J. Russell Ramsay is a licensed psychologist and board-certified cognitive-behavioral therapist specializing in the assessment and psychosocial treatment of adult ADHD. He was the co-founder and co-director of Penn's Adult ADHD Treatment and Research Program, one of the earliest and most influential programs of its kind, established in 1999. Dr. Ramsay is the author of six books on adult ADHD, including his most recent, Once I Get Started (2025). He has lectured internationally, published extensively in peer-reviewed journals, and serves on the editorial board of the Journal of Attention Disorders. He is an inductee in the CHADD Hall of Fame and recipient of the University of Pennsylvania's Szuba Award for Excellence in Clinical Teaching and Research. He now runs a fully virtual solo psychology practice, licensed in Pennsylvania and credentialed through PsyPact to practice telepsychology across 35+ participating states.

This week, Emily and Perry are coming in hot to discuss the existence of sex, specifically whether or not women have a DSM-5-designated disorder when they don't want it, or if that's a pathology designed to sell women meds. Turns out the data of sexual desire is a complicated and noisy thing to study, but fortunately that's a turn-on for our intrepid hosts. Plus: a diabetes conference gets politicized, losing sleep over getting sleep, and preventative HIV drugs in South Africa. Submit a question for our weekly mailbag at wellnessactually.fm. ParentData survey on sex after kids ParentData episode with Emily Nagoski Buy her book! Previous episodes referenced: What's the deal with testosterone? What's the deal with HRT? What's the deal with peptides?See omnystudio.com/listener for privacy information.

What if diagnosing PTSD, anxiety, and depression could be as objective as a blood test — done in 10 minutes on your phone?That's the vision behind Sensei, a company using AI and ocular biometrics to bring measurable, objective diagnostics to mental health. In this episode, host Deborah Westphal sits down with David Zakariaie, founder and CEO of Sensei, to talk about the science of the eye, a $2M technology problem solved with a commercial camera, and why fixing mental health starts with fixing measurement.Key TakeawaysMental health's biggest crisis isn't just a shortage of care — it's a measurement problem. Major depression, the most commonly diagnosed mental health condition in the U.S., is misdiagnosed approximately 65% of the time. PTSD, bipolar, and schizophrenia are misdiagnosed between 84–92% of the time.Sensei's diagnostic app shows patients a series of ocular stimuli for roughly 10.5 minutes, captures their eyes' responses via a standard smartphone camera, and outputs a binary diagnosis plus a severity score.The platform measures approximately 45 individual metrics across three categories: traditional ocular metrics (pupil size, blinks, saccades, gaze), iris dilator and sphincter dynamics (mapping sympathetic vs. parasympathetic nervous system activity), and heart rate and heart rate variability from facial video.Sensei is currently in Phase 3 clinical trials for a PTSD diagnostic, with an FDA submission planned for late 2025 and approval expected in 2027.About 16,000 people participated in pre-trial studies; the full dataset at submission is expected to reach approximately 30,000.The go-to-market strategy focuses on telehealth platform integration — partnering with companies like Spring Health, Talkspace, and BetterHelp to embed the diagnostic tool directly into existing care delivery workflows.Future expansion targets schizophrenia, bipolar disorder, and ADHD, with longer-term interest in neurodegenerative conditions like Alzheimer's and dementia.About David ZachariaDavid Zakariaie is the founder and CEO of Sensei, a mental health diagnostics company building the first FDA-regulatory-grade platform for diagnosing and monitoring PTSD, anxiety, and depression using AI-powered ocular biometrics. His path began at 15, when he attended Google I/O, received an early pair of Google Glass, and became fascinated with the scientific potential of the human eye. He left high school after 10th grade, taught himself to code, and launched the company in 2015.Resources & Links MentionedSensei: sensei.health (verify current URL)Mental Health Study (Phase 3 Trial Sign-Up): mentalhealthstudy.orgKaren Toffler Charitable Trust: tofflertrust.org (verify current URL)Parea Therapeutics (digital therapeutics reference)The CAPS-5 (Clinician-Administered PTSD Scale)The PCL-5 (PTSD Checklist for DSM-5)If You Enjoyed This EpisodeSubscribe to Research Renaissance wherever you listen to podcasts. If this conversation sparked something for you, share it with someone in healthcare, mental health advocacy, or neuroscience — this is the kind of work that needs more eyeballs on it.To learn more about the breakthroughs discussed in this episode and to support ongoing research, visit our website at tofflertrust.org. Technical Podcast Support by Jon Keur at Wayfare Recording Co.

Des centaines de fonds VC crypto arrivent en fin de vie avec des portefeuilles remplis de tokens que presque personne ne veut racheter. Thomas Klocanas, fondateur du fonds américain Strobe Ventures, et Alexandre Vinal, fondateur du fonds DSM, décortiquent la mécanique des valorisations maintenues artificiellement, les vraies stratégies de sortie des fonds (OTC, distributions in-kind, extension des véhicules) et les pressions cachées qui pèsent sur le marché. Vous saurez aussi quels tokens peuvent survivre à l'écrémage qui s'annonce.// ME CONTACTERJe m'appelle Gary Benezat, cofondateur de la stratégie DCY BTC Yield (https://dcy.fund), un fonds d'investissement market neutral dédié à Bitcoin. Notre objectif : générer du rendement sur du Bitcoin détenu à long terme, avec une volatilité proche de zéro.Depuis 2018, je travaille dans l'industrie des crypto-actifs et j'ai lancé en 2022 le podcast Crypto Coulisses avec une ambition claire : faire découvrir les coulisses de l'écosystème blockchain en donnant la parole aux meilleurs experts du secteur.Vous pouvez me contacter :✉️ Par mail : gb@dcy.io

Binge drinking can look harmless right up until it doesn't. If you only drink on weekends, vacations, or big nights out, it's easy to tell yourself you're fine because you're not drinking every day. But the consequences of one high-risk night can be life-changing, and clinically, intermittent heavy drinking can still meet criteria for an alcohol use disorder.I'm joined by Colleen Clifford, a former binge drinker who spent 36 years working at sea as a commercial fisherwoman and is now transitioning into health coaching to help clients manage binge drinking and binge eating. Colleen shares the personal grief that shaped her mission, the stories she used to justify “normal” partying, and the turning-point moment that made her drop alcohol for good. We also get practical about what actually counts as a binge, including how “one drink” is often smaller than the glass in your hand.We discuss the DSM-5 criteria for alcohol use disorder, how many people who binge drink do not think they have a problem, and why cravings can still show up years later. Colleen explains how she handles urges by observing them, naming the discomfort, and playing the tape forward. I also share a harm-reduction option many people don't know about: medications like naltrexone that, for some patients, can be taken before drinking to reduce binge episodes. We wrap with trends like alcohol-free wine and shifting drinking culture across generations, plus Colleen's core message: it only takes one moment of drinking too much to change your life forever.Subscribe, share this with someone who's questioning their relationship with alcohol, and please leave a review so more people can find the show.To learn more about Colleen and her work: https://purepotential.health/To contact Dr. Grover: ammadeeasy@fastmail.com

PSA: psychiatry does not have any case reports of diseases that are validated! This shortcoming of the DSM is why Luis dropped out of psychology and instead chose holistic psychology. As Luis sees it, behavior is not a fixed identity. There is no biochemical data proving “mental disease”. What we can track is neurotransmitters, like seratonin. 50-90% of these are made in the gut. Cue nutrition. Food is a shortcut to influencing change in the brain's biochemistry. Carbs influence glucose, which plays an active role in our mood. If you would like to track your glucose consider getting a glucose monitor like hellolingo.com for two weeks to gather data. Notice what you eat, how you feel, your activities, and your mood, all relative to the continuous glucose monitor's data. If you would like to see Luis' hellolingo.com glucose charts, tune in to the YouTube video version of this podcast.  If you are curious about using nutrition to support your mental health, check out our 6 month Embodied Nutrition Slow group, starting July 7th 2026,:https://www.holisticlifenavigation.com/slow-practice-nutrition-groupYou can read more about, and register for, the upcoming 6 month "Embodied Nutrition" program here: https://www.holisticlifenavigation.com/slow-practice-nutrition-group----You can learn more on the website: https://www.holisticlifenavigation.com/You can follow Luis on Instagram @holistic.life.navigationQuestions? You can email us at info@holisticlifenavigation.com

What kind of man gets studied at Yale, Brown, and Harvard, builds a 300 person international research consortium, and still has powerful people working to erase his name? Dr. Daniel Ingram is not a guru. He is a retired level one trauma emergency physician. A published neuroscience researcher. The author of a book that has shaped contemplative practice for tens of thousands of readers. The acting organizer of a global research effort spanning Harvard, Yale, Brown, Cambridge, and Oxford. By every credential medicine respects, he is one of their own.So why did a senior figure allegedly commission an academic article engineered to surface at the top of every search of his name, with one stated goal? That nobody would ever believe him again. Because Dr. Ingram crossed a line his profession does not permit. He claimed that awakening is real. That it is measurable. That it is observable in the brain.  We go into what he has seen at the edges of human perception. What he documented in the lab. What he believes medicine is doing to patients every single day by refusing to look.The Emergent Phenomenology Research Consortium

In this episode of The Body Grievers® Club, Bri joins therapist/social worker Monica Freudenreich to discuss eating disorders versus disordered eating, emphasizing that most people with eating disorders often go unrecognized or dismissed by providers who lack specialized training and may be influenced by diet culture trends. They describe how diagnostic labels can shift, how insurance and treatment systems affect care, and why focusing on functioning and quality of life matters more than whether someone meets a specific DSM threshold. They critique applying abstinence-based addiction models to food, highlight how "health" is often reduced to weight, and explore the roles of rest, connection, joy, and reducing shame in healing. They also preview an upcoming master class for providers and individuals on assessment, blind spots, body image, and practical strategies. 04:18 Recognizing Disordered Eating 06:58 Monica's ED Work Journey 09:55 Bri's ED Center Reality 12:41 Provider Dissonance Dieting 18:57 Labels Don't Matter 25:42 Healing Inside Diet Culture 35:36 Rest as Radical Health 37:25 Rethinking Addiction and Connection 38:54 Comfort Coping Without Shame 47:55 Rejecting Diet Culture 50:18 About the Masterclass   EPISODE RESOURCES: Join our upcoming masterclass: Eating Disorder vs. Disordered Eating Johann Hari: Everything you think you know about addiction is wrong https://www.youtube.com/watch?v=PY9DcIMGxMs  Episode 37: Rest Feels Unsafe Get on the waitlist for Body Image Bootcamp for providers at https://bodyimagewithbri.mykajabi.com/bootcamp-waitlist-2025    WANT MORE OF MONICA FREUDENREICH? https://www.monicafreudenreich.com/    WANT MORE OF BRI? *Instagram: @bodyimagewithbri
 *Website: https://bodyimagewithbri.com/ *Bri's Free Resource: 7-Step Guide to Shift Body Grief to Radical Body Acceptance https://www.bodyimagewithbri.com/seven-steps

I sit down with Dr. Jennifer Huffman, a board-certified pediatric neuropsychologist, PDA woman with lived experience, and creator of the Neurodynamic Navigator System and the Neurodynamic Quotient. After twenty-five years working with children whose profiles were called often called ODD (Oppositional Defiant Disorder), she developed a framework to make the dynamic, fluctuating nature of the PDA brain visible and usable for parents, teachers, and clinicians.We talk about her childhood as an undiagnosed PDA autistic person, why ODD as a diagnosis isn't helpful, how she assesses children who cannot come into an office, and the app she is building to help families. After all that great insight, just her closing message for parents of PDA kids in burnout makes this episode worth a listen.Key TakeawaysGrowing Up as an Undiagnosed PDA Autistic Neuropsychologist | 00:02:48 Dr. Huffman describes a childhood marked by academic failure in math from third grade, severe bullying that led her parents to drive her thirty minutes each way to attend school in a different town, and the recurring experience of being told she was not living up to her potential. She names the specific mechanism she now recognizes in herself: she cannot process on demand. If someone tells her to do something, or if it feels redundant, her brain shuts off. This is not willfulness. It is the same mechanism she has spent twenty-five years helping children and families understand. She describes finding neuropsychology in her third year of undergraduate study as a light bulb moment, not because she wanted a career but because she was trying to figure out her own brain.The ODD Buster: Why Oppositional Defiant Disorder Is So Often the Wrong Label | 00:12:39 Dr. Huffman describes spending twenty-five years working with the complex cases other clinicians could not crack, children who had been given ODD diagnoses and whom nobody wanted to work with. She calls herself the ODD buster and states directly that in her clinical experience, she has rarely seen a child who actually had ODD. What she consistently found underneath that label was high empathy, anxiety, sensory differences, social communication differences, and learning differences, often in combination. She names ODD as an example of a DSM category built by non-neurodivergent clinicians describing externalized behavior without curiosity about what is underneath it.How She Assesses Children Who Cannot Come Into an Office | 00:17:38 Dr. Huffman explains that when a child is in burnout and cannot access evaluation, the work does not begin with the child. It begins with the parent: helping them advocate with the school, coordinating with medical providers who may not understand why the child cannot leave the house, and slowly building a relationship with the child themselves. She describes spending six months to a year playing Minecraft with a child before any formal assessment data is collected, and names this as genuinely valuable clinical time. She also holds PSYPACT certification, which allows her to work with families across most of the United States without the family ever entering her office.The Neurodynamic Quotient: Making the Dynamic Nature of the PDA Brain Visible | 00:36:57 Dr. Huffman introduces the Neurodynamic Quotient, her framework for understanding why PDA children can do something one day and appear to lose the skill the next. The formula combines dynamic safety, which includes felt safety, connection, information, and autonomy, with dynamic capacity, which includes the battery, sensory load, and executive functioning scaffolding, plus motivation. She explains why autonomy functions as a multiplier: if it reaches zero, the entire product is zero regardless of how much skill or capability is present. She also names motivation as the variable parents and teachers most often misuse, pushing past natural capacity because the child demonstrated what they were capable of once.Do Not Get in Front of Your Child | 00:55:03 Dr. Huffman closes with a message for parents whose children are in burnout. She names never assuming the child is not capable as the most important thing a parent can hold onto, and shares her own story as evidence: her parents could not have predicted she would become a neuropsychologist. She uses the phrase "do not get in front of your child" to mean: if they have something they want to do, let them fly. The child who is in their room with the lights off on Minecraft is telling you what they need. Meeting that need and staying regulated yourself is what moves them through burnout faster than fighting against it.Relevant ResourcesUnderstanding PDA — Free class with context on the nervous system disability framework and the dynamic, cumulative nature of activation Dr. Huffman builds on throughout this conversationBurnout — Free class with context for the red zone experience Dr. Huffman describes and the burnout recovery process for both children and parentsParadigm Shift Program — Our signature program where parenting for autonomy, safety, and connection is taught in fullUnlocking the PDA Brain by Dr. Jennifer Huffman — Dr. Huffman's book introducing the Neurodynamic Navigator System, written as a manual for understanding and supporting the PDA brainThe Able Center — Dr. Huffman's private neuropsychology practice in IllinoisThe Baby Fold — The Illinois nonprofit where Dr. Huffman serves as Vice President of Clinical Operations, specializing in trauma and higher support needs neurodivergent childrenBeyond Behaviors by Mona Delahooke — Mentioned by Dr. Huffman for understanding what is happening beneath the behavior in neurodivergent childrenDr. Huffman is also a board member of PDA North America.

“Şişşşt… Aramızda kalsın, yiyip yiyip kusuyormuş.”Bulimiya hakkında konuşurken çoğu zaman sadece iki davranıştan bahsediyoruz: yemek ve kusmak.Ama işin görünmeyen tarafı çok daha büyük.Yemekten keyif alamamak.Sürekli yemek düşünmek.Kusmak için uygun zamanı kollamak.Yakalanmamaya çalışmak.Kokuyu gizlemek.Yüzündeki kızarıklığı saklamak.Ve en önemlisi…UTANMAK. Bu bölümde bulimiyanın DSM-5 tanımını konuşuyoruz ama orada kalmıyoruz.Bulimiyanın psikolojik ve fizyolojik sebeplerinden, binge eating ile olan ilişkisinden, Brené Brown'ın utanç araştırmalarından ve iyileşmenin nasıl mümkün olduğundan bahsediyoruz.Eğer siz ya da sevdiğiniz biri bulimiya ile mücadele ediyorsa, bu bölüm size yalnız olmadığınızı hatırlatmak için burada.

Is our mental health system helping children or simply getting better at labeling them? With some reports suggesting that 70% of adolescents are struggling with mental health issues, host Gabe Howard asks the tough question: Is it possible that the majority of teenagers are truly "sick" or is there a flaw in how we calculate and categorize human distress? Joining the show is Dr. Will Dobud, a social worker, researcher, and co-author of “Kids These Days: Understanding and Supporting Youth Mental Health.” Dr. Dobud pulls back the curtain on the clinical world, revealing that a staggering number of psychologists have concerns about the validity of the DSM, the very book used to dictate treatment and insurance coverage. He argues that the "expert-led" model often ignores the most predictive factors of success: the therapeutic relationship and the child's own engagement. Listener Takeaways Learn why the therapeutic bond and the child's belief in the treatment are more predictive of recovery than the specific clinical interventions used. Learn how to perform a "resource audit" to identify your child's strengths and support systems rather than focusing exclusively on clinical deficits. Learn why a child's belief that they are in the right place is the primary driver of improvement. Navigate the insurance system to ensure a child gets care without receiving a "severe and persistent" label that sticks with them for life. In this candid conversation, Dr. Dobud explains his philosophy of "crew, not passengers," encouraging parents to focus on what works rather than getting hung up on what they feel they “should” be doing. This episode is a must-listen for any caregiver who wants to support their child's mental well-being while honoring their autonomy and long-term potential.  * * * "The (child) is not the problem. The problem is the problem."~Dr. Will Dobud, co-author of Kids These Days * * * Our guest, Dr. Will Dobud, is a social worker, researcher, and educator who has worked with adolescents and families in the United States, Australia, and Norway. Will is from Washington, D.C., and divides his time between the United States and Australia each year. Will is an award-winning researcher and educator who has received recognition for excellence in research, teaching, and crime prevention. Dr. Dobud is a Senior Lecturer in Social Work at Charles Sturt University, Australia's largest social work school. Will is an invited international speaker who conducts workshops for therapists and families around the globe. Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington. Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can't imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com. Please share the show with everyone you know! Learn more about your ad choices. Visit megaphone.fm/adchoices

Jay Gunkelman goes in BLIND on Case 9 — an 18-year-old's eyes-open EEG, age only, no history. Joshua Moore bet his car on a left posterior concussion. Jay sees something deeper: a thalamocortical dysrhythmia at the anterior cingulate, slow and fast rhythms coupled together, beta spindling above 30 Hz that most databases can't even see. Left-side mu disconnect shutting down the language hemisphere. Posterior insula, left side. After half a million EEGs, Jay's verdict isn't a diagnosis — it's a phenotype that tells you how to treat it, not what to call it.

American psychiatry has built a sociological armor around itself that protects it from reform. The armor has two parts. Reverence and complexity. Together they form the most effective institutional defense system in American professional life. And the apparatus, in 2026, has evolved its most refined defensive move yet, the DSM-6 roadmap, which absorbs the entire body of structural critique against the field by publishing thoughtful documents acknowledging the critique is correct, while channeling an entire generation of reform energy into bureaucratic processes that will conclude, eventually, with the publication of a new manual that incorporates the language of the critique without changing what the manual does. Why the apparatus persists despite forty years of evidence it is failing. How residency capture, modality capture, and credentialing capture work together to produce a workforce whose tolerance for the mystery of the work has been systematically lowered. What would have to change. And why none of the obvious answers are actually answers. This episode covers: Of Two Minds. Tanya Luhrmann's anthropology of American psychiatric residency. How young doctors who enter training wanting to think across biological and psychological registers get formed, by the reward structure of training itself, into single-register practitioners. Why this is happening right now to the residents who started in 2025, and why the AI replacement is going to be welcomed by the field that has been preparing for it for a generation. How Aaron Beck got eaten. The careful, curious clinician who let his data change his mind. The three properties of cognitive therapy that made it perfectly compatible with the emerging managed care apparatus. Why Beck himself was not the version of Beck that got reproduced in the training programs. The selection pressure that captures every modality with the same properties, regardless of the founder's intent. The ABA parallel. Ivar Lovaas, the 1987 study, the autism insurance mandates, the BACB explosion. Why Applied Behavior Analysis became mandatory standard of care despite extensive evidence of harm from the autistic community. Henny Kupferstein on PTSD outcomes. The Autistic Self Advocacy Network. Private equity acquisition of ABA chains and what the moral crumple zone looks like at scale. Measurement as the real religion. The PHQ-9 and GAD-7 as Pfizer-funded screening instruments that became, by capture and convenience, the definitions of depression and anxiety in American clinical practice. Campbell's Law. Goodhart's Law. Theodore Porter on quantification as defense against weak internal authority. The IAPT case study from England, Layard's economic argument, David Clark's CBT rollout, Michael Scott's outcome research, Farhad Dalal's cognitive-behavioral tsunami. Why the entire international model of measurement-based care produces excellent statistics and very little durable change. The critics the apparatus could not absorb. Robert Whitaker on long-term outcomes and Anatomy of an Epidemic. Joanna Moncrieff and the 2022 serotonin meta-analysis that should have ended the chemical imbalance theory and didn't. Lisa Cosgrove on DSM-5-TR financial conflicts of interest. Why each of them produced exactly the kind of evidence that should have triggered structural reform, and why the apparatus dismissed each of them through credentialing arguments that were really about boundary policing. The DSM-6 trap. The closure-of-the-trap argument. Why the DSM-6 roadmap, which concedes the entire structural critique, is the apparatus's most sophisticated defensive move yet. Why being invited to participate in the DSM-6 working groups is the mechanism by which the next decade of reform energy gets neutralized. Why the manual is downstream of the apparatus and reforming the manual cannot reform the apparatus. Enshittification of care. Cory Doctorow's framework applied to American mental health. The four constraints that should have prevented it. How each was eliminated. Madeleine Clare Elish on moral crumple zones. Why clinicians absorb the moral and financial cost of an apparatus they did not design. The diploma mill. The accreditation conflict of interest. Why MSW programs, counseling programs, and PsyD programs have doubled their output without any accountability for what they produce. The accountability inversion. The structural fix. Why schools and boards should be liable for the clinicians they produce. Why the field needs both rigorous selection and rigorous accountability, and how the current system has neither. What would change if the field stopped being a diploma mill. Why this is not a return to Freud's priest class. Disagreement was the wisdom. Why the productive conflict between schools of thought was where psychology was actually thinking, and why the DSM-III atheoretical move killed the conversation that produced wisdom. Neither side wins. Why the cold machine and the warm ghost both need each other. Why the answer is not to defeat the apparatus but to stop mistaking it for the work. The coda. The Machines Will Start to Dream. The actual ending of the series. Why you do not need a conspiracy theory for any of this. The cold machines are nothing, the warm ghost is everything. The microcosm is the macrocosm because the systems are human. The AI threat as reality splitting, where the simulated layer becomes thick enough that the substrate underneath stops being accessible. Freud's permanent problem. Bureaucracy as the most successful avoidance technology humans have ever invented. The disbelief at the root. The question of whether you are more scared of yourself than of not seeing life clearly. The wager that even if humans always refuse, professional psychology should stop being the most refined refusal in the culture. About the host: Joel Blackstock is a Licensed Independent Clinical Social Worker and Clinical Supervisor, the Clinical Director of Taproot Therapy Collective in Hoover, Alabama, and the author of work on Brainspotting, Emotional Transformation Therapy, qEEG neurofeedback, somatic and depth approaches to trauma. Find more at gettherapybirmingham.com. This is the final episode of a nine-part series. #PsychotherapyOnTheCouch #AmericanConfession #DSMReform #DSM6 #DSMCritique #DiagnosticAndStatisticalManual #APA #AmericanPsychiatricAssociation #PsychiatryReform #MentalHealthReform #PsychotherapyReform #TanyaLuhrmann #OfTwoMinds #PsychiatricResidency #AaronBeck #CognitiveTherapy #CBT #CognitiveBehavioralTherapy #ABA #AppliedBehaviorAnalysis #IvarLovaas #BACB #AutismRights #AutisticSelfAdvocacy #ASAN #HennyKupferstein #PHQ9 #GAD7 #MeasurementBasedCare #CampbellsLaw #GoodhartsLaw #TheodoreporPorter #TrustInNumbers #IAPT #RichardLayard #DavidClark #MichaelScott #FarhadDalal #CognitiveBehaviouralTsunami #RobertWhitaker #AnatomyOfAnEpidemic #MadInAmerica #JoannaMoncrieff #SerotoninHypothesis #ChemicalImbalance #SSRIs #Antidepressants #LisaCosgrove #PsychiatryUnderTheInfluence #ConflictOfInterest #PharmaInfluence #BigPharma #Enshittification #CoryDoctorow #RotEconomy #EdZitron #MoralCrumpleZone #MadeleineCElish #InsuranceMentalHealth #GhostNetworks #MentalHealthParity #DiplomaMill #SocialWorkEducation #MSWPrograms #PsyD #CounselingEducation #CACREP #CSWE #APAAccreditation #LicensingBoards #ClinicalSupervision #AccountabilityInversion #PsychotherapyTraining #PsychiatricTraining #PsychologyHistory #PsychiatryHistory #FreudCivilizationDiscontents #JungianTherapy #DepthPsychology #SomaticTherapy #TraumaTherapy #ComplexTrauma #AITherapy #AIReplacingTherapists #ChatGPTTherapy #FutureOfTherapy #PsychotherapyPodcast #PsychiatryPodcast #PsychologyPodcast #MentalHealthPodcast #ClinicalSocialWork #JoelBlackstock #LICSW #TaprootTherapy #BirminghamAlabama #AlabamaTherapy #HooverAlabama #ColdMachinesWarmGhosts #TheMostSacredThingWeHave #TheMachinesWillStartToDream #WarmGhost #ReverenceAndComplexity #ProfessionalCapture #InstitutionalCapture #RegulatoryCapture #EvidenceBasedPractice #EvidenceBasedCritique #BiologicalPsychiatry #PsychiatryEpistemology

This episode continues the Heal NPD Seminar Series with Dr. Mark Ettensohn, joined by his associates Deanna Young, Psy.D., and Danté Spencer, Ph.D. In this session, the group examines the Alternative DSM-5 Model for Personality Disorders (AMPD), a dimensional framework introduced in Section III of the DSM-5 and retained in DSM-5-TR. The model was developed in response to longstanding limitations of the traditional categorical system, including diagnostic overlap, heterogeneity within disorders, and the absence of a clear framework for assessing severity. The discussion focuses on the two core components of the model. The first, Level of Personality Functioning (Criterion A), assesses impairments in identity, self-direction, empathy, and intimacy. This portion of the model reflects a structural approach to personality and aligns with psychodynamic and developmental perspectives on personality organization. The second component, Criterion B, introduces a trait-based system organized around five domains: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. These traits are derived from dimensional personality research and represent an effort to describe maladaptive personality features in a standardized way. The group explores the strengths of this combined model, as well as its limitations. Particular attention is given to the tension between structural and trait-based approaches, and to the question of whether personality pathology can be adequately captured through trait descriptions alone. Using narcissistic personality disorder as a focal example, the discussion examines how the model emphasizes grandiosity and attention-seeking traits while underrepresenting vulnerability, shame, and fluctuations in self-state. The conversation highlights the importance of understanding pathological narcissism as a system of self-esteem regulation rather than a fixed set of traits. Key themes include: The shift from categorical to dimensional models of personality disorder The distinction between personality functioning (structure) and personality traits (style) Limitations of trait-based approaches in capturing dynamic, state-based phenomena The role of self-esteem regulation, vulnerability, and oscillation in narcissistic pathology Clinical implications for diagnosis, formulation, and treatment Throughout, the discussion situates the AMPD as a meaningful step forward in personality disorder classification, while also identifying areas where the model remains conceptually limited. The session emphasizes the value of structural and developmentally informed approaches in understanding personality pathology. This series is intended for clinicians, trainees, and viewers seeking a nuanced, non-moralizing understanding of narcissism and personality disorders. To learn more about our work, visit: www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Citation:  American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). Link to alternative model:   https://psychiatryonline.org/doi/10.1... About Heal NPD Heal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy, and consultations for partners and family members. Learn more or inquire about services: https://healnpd.org

This episode continues the Heal NPD Seminar Series with Dr. Mark Ettensohn, joined by his associates Deanna Young, Psy.D., and Danté Spencer, Ph.D. In this session, the group discusses the paper “Living with Pathological Narcissism: A Qualitative Study” (Day et al., 2020), which examines narcissistic personality pathology from the perspective of partners and family members. Unlike most research on narcissism, this study does not rely on self-report or clinician ratings. Instead, it draws on qualitative descriptions from over 400 individuals in close relationships with someone exhibiting high levels of pathological narcissistic traits. These accounts provide a window into how narcissism is experienced interpersonally, particularly in intimate and long-term relationships. The discussion focuses on the study's central finding: that pathological narcissism is best understood as a system characterized by the co-occurrence of grandiosity and vulnerability. Loved ones described patterns of entitlement, arrogance, and need for admiration alongside insecurity, hypersensitivity, emotional instability, and chronic feelings of emptiness. In the majority of cases, these features were not separate “types,” but fluctuating states within the same individual. The group explores how these findings challenge common assumptions about narcissism, including the tendency to equate it with overt grandiosity or interpersonal abusiveness. Particular attention is given to the limitations of DSM-based models, which emphasize observable traits while underrepresenting the internal dysregulation and vulnerability that define the disorder. The conversation also examines broader relational and developmental themes, including: The oscillation between grandiose and vulnerable self-states The role of dissociation and splitting in personality organization The impact of early attachment trauma and “empathic failures” How narcissistic dynamics are expressed and amplified within close relationships The tendency for polarized, dehumanizing narratives to emerge in response to relational injury Finally, the group discusses the concept of “narcissistic abuse,” noting that while experiences of harm in these relationships are real and often significant, the term itself is not a well-defined clinical construct. The discussion emphasizes the importance of distinguishing between lived experience and explanatory frameworks, and of maintaining a nuanced, non-reductive understanding of personality pathology. Key themes include: Pathological narcissism as a dysregulated self-state system The interdependence of grandiosity and vulnerability Limitations of categorical and trait-based models of narcissism The relational expression of personality pathology The role of trauma, attachment, and development in narcissistic adaptation Clinical implications for assessment, formulation, and treatment This series is intended for clinicians, trainees, and viewers seeking a nuanced, clinically grounded understanding of narcissism beyond popular discourse. To learn more about our work, visit: www.HealNPD.org Additional Resources: Newsletter: https://healnpd.substack.com Assessment and therapy inquiries: https://healnpd.org/contact Purchase Unmasking Narcissism: A Guide to Understanding the Narcissist in Your Life: https://amzn.to/3nG9FgH LISTEN ON APPLE PODCASTS: https://rb.gy/cklpum LISTEN ON GOOGLE PODCASTS: https://rb.gy/fotpca LISTEN ON AMAZON MUSIC: https://rb.gy/g4yzh8 Citation: Day, N. J. S., Townsend, M. L., & Grenyer, B. F. S. (2020). Living with pathological narcissism: A qualitative study. Borderline Personality Disorder and Emotion Dysregulation, 7(19).  Full Text Link: https://pmc.ncbi.nlm.nih.gov/articles... About Heal NPD Heal NPD is a clinical practice specializing in the assessment and treatment of pathological narcissism, narcissistic personality disorder, and related personality difficulties. We offer comprehensive diagnostic assessments, individual psychotherapy, and consultations for partners and family members. Learn more or inquire about services: https://healnpd.org

Is it Time for a New Approach to Emotional Suffering? Advantages and Disadvantages of DSM Diagnoses Hosts: Kevin Cornelius, LMFT Dr. David Burns Episode Summary In this thought-provoking episode, Dr. David Burns and host Kevin Cornelius, LMFT explore a topic that shapes nearly every corner of modern mental health care: psychiatric diagnosis. For decades, the Diagnostic and Statistical Manual of Mental Disorders (DSM) has defined how clinicians diagnose, treat, and research emotional suffering. But what if many of these diagnostic categories don't represent distinct medical diseases? What if they are simply normal human emotions—like sadness, anxiety, or shame—occurring on a spectrum? Dr. Burns draws on decades of clinical experience, research, and insights from TEAM-CBT to question the assumptions behind psychiatric labeling. While diagnoses can sometimes reduce stigma or help people access care, they can also unintentionally shape identity, medicalize everyday emotional struggles, and distract from the real drivers of emotional pain. This episode offers a nuanced conversation about labels, measurement, therapy, and what actually helps people recover from depression and anxiety. In This Episode You'll Learn What the DSM is—and why it became so influential How the DSM functions as the "diagnostic bible" of psychiatry Why the system was originally designed for research standardization, not necessarily for everyday clinical treatment The difference between true mental disorders and normal emotional experiences Examples of genuine brain disorders such as schizophrenia and bipolar I disorder Why many DSM diagnoses describe normal emotions taken to an extreme How everyday struggles became medical diagnoses Shyness becoming "social anxiety disorder" Chronic worry becoming "generalized anxiety disorder" Why time-based thresholds (like "14 days of depression") can be arbitrary The unintended consequences of diagnostic labels How labels can reinforce feelings of shame or defectiveness Why diagnoses can sometimes lead to over-medicalization and medication-focused care Why measurement matters more than diagnosis in therapy Dr. Burns explains how simple mood scales can quickly assess a patient's emotional state Research showing that DSM diagnoses often add little predictive value for treatment outcomes A surprising research finding After lengthy diagnostic interviews, clinicians were only 3–5% accurate at estimating patients' feelings in the moment What this reveals about the limits of traditional diagnostic approaches Why focusing on thoughts may be the key According to cognitive research, negative thoughts drive emotional suffering Effective therapy focuses on identifying and transforming these thoughts Hope for people who feel defined by a diagnosis Why diagnoses do not determine your ability to recover How targeted cognitive techniques can sometimes produce rapid improvements—even within a single session Benefits of Diagnosis (According to Dr. Burns) While the episode critiques diagnostic labeling, the conversation also highlights situations where diagnoses can help: Access to insurance coverage Eligibility for disability or academic accommodations Temporary relief from self-blame Clear communication in research studies Key Takeaway Mental health diagnoses can sometimes be useful administrative tools—but they should never define who you are. Real healing often comes from understanding the specific thoughts, moments, and experiences that drive emotional pain, and learning practical methods to change them. Mentioned in This Episode Dr. Burns' article: "Is It Time for a New Approach to Emotional Suffering?" (Psychology Today) TEAM-CBT approach to psychotherapy Brief Mood Survey and other measurement tools used in therapy Memorable Quote "We treat humans, not disorders." Connect & Learn More Read Dr. Burns' latest articles on Psychology Today Explore more tools and resources at FeelingGood.com Learn about TEAM-CBT training and techniques If you enjoyed this episode, please consider subscribing, sharing the podcast, or leaving a review. It helps more people discover tools for overcoming depression and anxiety. Let Us Know What You Think of This Episode Please use this link to take a very brief survey and share your opinion with us about this episode Contact Information Kevin Cornelius, LMFT is a Level 5 Certified Master TEAM-CBT Therapist and Trainer and the Clinical Director of Feeling Good Institute--Silicon Valley. He specializes in the treatment of trauma, anxiety, depression, relationship problems and insomnia. You can reach Kevin at kevin@feelinggoodinstitute.com and visit his website at www.tools4change.me. You can reach Dr. Burns at david@feelinggood.com. Feeling down in these turbulent times? Take a ride on our Feeling Great app. Feeling Great feels wonderful! You owe it to yourself to feel GREAT! Give the Greatest Gifts of ALL--Love and Happiness!

Hey what's up hello! This week, we're chatting with Ashley Koch, who recently got their Master's degree in Counseling! Ash shares their experience in their Master's program, asexuality in the DSM-5-TR, counselor competency as an asexual person, and the lack of LGBTQ+ education in counseling courses.Follow Ashley: @ash_artworkListen to Ashley's podcast: https://open.spotify.com/show/5ItTyifF7DAyNOMxxKFM9F?si=O31P9ICrQVC4Qs9Z1EmONQDonate: patreon.com/soundsfakepod  Follow: @soundsfakepod    Join: https://discord.gg/W7VBHMt  www.soundsfakepod.comBuy our book: www.soundsfakepod.com/book

Jay Gunkelman goes in BLIND on Case 8 — a 30-year-old whose eyes-open EEG looks like eyes-closed. Alpha at 150 microvolts. Widespread. Anteriorized. Not responding to eye opening. After half a million EEGs, Jay calls the phenotype on sight: vigilance regulation problem, not attention. Left-side mu disconnect. Right-parietal alpha persistence. Frontal alpha hyper-coherence climbing from 0.5 eyes-open to 0.6+ eyes-closed — affect regulation flag. Plus a treatment map more granular than the room expected: FC beta for salience activation, C3 for language, C4 for affect, C4-to-PZ for the parietal alpha that won't quit. And a history segment most listeners have never heard — the first transmitted EEG in 1974, phase-lock loops over voice-grade phone lines, Trudy and Eric Gibbs, Larry Wood's engineering. Stay for the inter-rater reliability number that should end the classical-EEG debate: 90% on phenotypes vs 30-40% on traditional reads.

Send us Fan MailDefiance can look like disrespect, but what if it is really stress, shame, and a nervous system that cannot downshift? We pick up our series on oppositional defiant disorder (ODD) with a clear, parent-friendly breakdown of what ODD is, how common it is, and why it is most often diagnosed in kids and teens. We also talk through why the label gets missed or brushed off, even though it has been in the DSM for decades.From there, we dig into the risk factors that show up again and again: ADHD and emotional dysregulation, trauma and adverse childhood experiences, high-conflict homes, and inconsistent discipline that turns rules into a moving target. We also cover how autism spectrum traits, learning disabilities, sensory processing challenges, and executive functioning deficits can lower frustration tolerance and make everyday demands feel impossible. If you have ever wondered why a child seems to argue everything, explode fast, or blame others, we connect those behaviors to what may be happening underneath without excusing harm.We get practical about what helps: structure, predictability, fewer power struggles, and stronger positive reinforcement so the only attention is not tied to the worst moments. We talk therapy tools like cognitive behavioral therapy (CBT), why family therapy can change the whole household dynamic, and how repairing trust often starts with adults regulating themselves and owning mistakes. We also answer the medication question plainly: no medication is specifically approved for ODD, but treatment can include meds for co-occurring ADHD, depression, or severe mood instability under psychiatric guidance.You will also hear our “winner of the week” rescue dog story plus a shelter spotlight on May, who needs a home. If this helped you, subscribe, share it with a parent or teacher, and leave us a review. What part of ODD feels the most familiar in your world right now?Recorded May 11, 2026FIND ME:My Website: https://motorcityhypnotist.com/podcastMy social media links: Facebook:  https://www.facebook.com/motorcityhypnotist/YouTube: https://www.youtube.com/channel/UCCjjLNcNvSYzfeX0uHqe3gATwitter: https://twitter.com/motorcityhypnoInstagram: motorcityhypnoFREE HYPNOSIS GUIDEhttps://detroithypnotist.convertri.com/podcast-free-hypnosis-guidePlease also subscribe to the show and leave a review.(Stay with me as later in the podcast, I'll be giving away a free gift to all listeners!)Change your thinking, change your life!Laugh hard, run fast, be kind.  David R. Wright MA, LPC, CHTThe Motor City Hypnotist

This episode explores the growing issue of body image struggles and eating disorders among men, examining how cultural pressures and online environments—particularly the Manosphere—shape perceptions of masculinity, worth, and identity.Gunter Swoboda discusses clinical insights into muscle dysmorphia, steroid use, and the increasing pressure men face to view their bodies as measures of status and value. The episode also explores practical pathways toward developing healthier relationships with the body and reconnecting with genuine wellbeing.Key Topics• The influence of the Manosphere on men's body image• Clinical insights into muscle dysmorphia and steroid use• Understanding interoceptive awareness and why it matters• Societal and cultural factors reinforcing toxic masculinity• Practical approaches toward healthier body relationshipsSound Bites“The clinical consequences are really real, very real.”“Muscle dysmorphia is a distorted perception of the body.”“The path forward is clinical.Inside This Episode• Understanding the growing body image crisis among men• How the Manosphere shapes male body standards• Exploring muscle dysmorphia and its consequences• Competition, acquisition, and body image pressures• The crisis of recognition and identity in men• The role of algorithms in reinforcing unrealistic standards• Reframing the relationship with the body• Practical pathways toward healing and self-understandingResourcesButterfly Foundation Helplinehttps://butterfly.org.au/DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition)https://www.psychiatry.org/psychiatrists/practice/dsmInteroceptive Awareness Researchhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362784GratitudeWe want to extend a huge thank you to our listeners in Fairborn, Grafton, Maple Heights, and Findley for bringing Ohio to #1 on our Top USA listeners list!! And to our Global Listeners, a special shoutout to our listeners in Mainz (mine-s), Emmerich (em-uh-rick), and Mannheim (man-hyme) for pushing Germany to #5 on our global listeners list! CONGRATULATIONS!! you made the Top Listeners List.Become a supporter of this podcast: https://www.spreaker.com/podcast/inspire-change-with-gunter--3633478/support.PatreonIf this episode resonates with you and you'd like to go deeper into practical exercises and guided reflection, Gunter offers extended self-development resources and exercises through our Patreon community: www.patreon.com/inspirechangeSponsorDistil UnionThis episode of Inspire Change with Gunter is brought to you by Distil Union, creators of beautifully designed, functional everyday carry accessories that help bring organization, simplicity, and intention into your daily life.Distil Union blends craftsmanship with thoughtful design to help you carry what matters most — without the clutter.

The actor and travel writer Andrew McCarthy used to be a member of one of pop culture's most famous friend groups: The Brat Pack. He starred in movies like Pretty in Pink and St. Elmo's Fire and palled around with actors like Rob Lowe and Emilio Estevez.Four decades later, in middle age, he found himself nearly friendless and set out on a cross-country road trip to reunite with the buddies he missed the most. This week on DSM, he tells Anna about the awkward conversations and tender moments that led to his new book Who Needs Friends: An Unscientific Examination of Male Friendship Across America. This episode was produced by Cameron Drews. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com.Need to set up your Slate Plus feed? If you subscribed through Slate.com, check out our FAQ at slate.com/podcastfaqs for easy instructions. Members subscribed via Apple Podcasts get automatic access—no setup required. Hosted on Acast. See acast.com/privacy for more information.

The actor and travel writer Andrew McCarthy used to be a member of one of pop culture's most famous friend groups: The Brat Pack. He starred in movies like Pretty in Pink and St. Elmo's Fire and palled around with actors like Rob Lowe and Emilio Estevez.Four decades later, in middle age, he found himself nearly friendless and set out on a cross-country road trip to reunite with the buddies he missed the most. This week on DSM, he tells Anna about the awkward conversations and tender moments that led to his new book Who Needs Friends: An Unscientific Examination of Male Friendship Across America. This episode was produced by Cameron Drews. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

The actor and travel writer Andrew McCarthy used to be a member of one of pop culture's most famous friend groups: The Brat Pack. He starred in movies like Pretty in Pink and St. Elmo's Fire and palled around with actors like Rob Lowe and Emilio Estevez.Four decades later, in middle age, he found himself nearly friendless and set out on a cross-country road trip to reunite with the buddies he missed the most. This week on DSM, he tells Anna about the awkward conversations and tender moments that led to his new book Who Needs Friends: An Unscientific Examination of Male Friendship Across America. This episode was produced by Cameron Drews. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

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

Send us Fan MailDefiance gets blamed on attitude, laziness, or “bad parenting,” but what if the real issue is a nervous system that can't calm down fast enough? We dig into oppositional defiant disorder (ODD) in a clear, practical way, breaking down what the diagnosis actually means and why it's so often misunderstood. If you've ever watched a child or teen go from fine to furious in seconds, this conversation helps you see what may be happening beneath the surface. We walk through the DSM-5 framework for ODD, including the three big clusters clinicians look for: angry or irritable mood, argumentative or defiant behavior, and vindictiveness. We also talk about everyday signs people notice, like frequent tantrums, constant arguing, refusing rules, blaming others, and being easily annoyed, then explain the key point that separates ODD from typical boundary pushing: intensity, consistency, and real impairment across home, school, and social life. We also place ODD in context, including how it first appeared in the DSM in 1980 and why it differs from conduct disorder, which involves more serious, planned violations. From there, we get into what research and lived experience often point to: emotional dysregulation, executive functioning challenges, stress, trauma, ADHD, anxiety, depression, and other neurodevelopment factors that can combine into a perfect storm. We close with why families can miss the deeper issue at first and preview a Part Two with more support and next steps. If this helped you rethink what “defiance” can mean, subscribe, share this with a parent or educator, and leave a review so more people can find it.Recorded May 11, 2026FIND ME:My Website: https://motorcityhypnotist.com/podcastMy social media links: Facebook:  https://www.facebook.com/motorcityhypnotist/YouTube: https://www.youtube.com/channel/UCCjjLNcNvSYzfeX0uHqe3gATwitter: https://twitter.com/motorcityhypnoInstagram: motorcityhypnoFREE HYPNOSIS GUIDEhttps://detroithypnotist.convertri.com/podcast-free-hypnosis-guidePlease also subscribe to the show and leave a review.(Stay with me as later in the podcast, I'll be giving away a free gift to all listeners!)Change your thinking, change your life!Laugh hard, run fast, be kind.  David R. Wright MA, LPC, CHTThe Motor City Hypnotist

Episode 8: The AI Therapist, the Generational Wound, and the Real Medicine The American mental health workforce is on track to be displaced by AI within ten years—and the psychiatric establishment isn't fighting it. They are welcoming it. Backed by venture capital and smoothed by insurance endorsements, AI therapy platforms are the ultimate fulfillment of what the "apparatus" has been building toward for 40 years: a delivery mechanism for psychotherapy that finally removes the unpredictable, unmeasurable human from the room. In Part 8 of this 9-part series, we expose what the AI replacement will actually do to the field of psychology, and why the variables that truly drive healing are the exact ones the industry pretends do not exist. In this episode, we explore: The AI Takeover: The meeting in San Francisco, what is actually being built, and why the psychiatric apparatus embraces the automation of therapy. The Generational Wound: How trauma shifts from the Greatest Generation to Gen Alpha, and the specific therapeutic interventions the "AI generation" is being shaped to need. The Convergent Rediscovery of Depth Psychology: How independent pioneers—including Richard Schwartz (IFS), Peter Levine (Somatic Experiencing), Bessel van der Kolk, Stephen Porges (Polyvagal Theory), and David Grand (Brainspotting)—all converged on the exact same picture of how trauma lives in the nervous system. The Dodo Bird Verdict & The Real Active Ingredient: Why 30 years of empirical research points to the therapist's regulated nervous system as the primary driver of successful outcomes—and why the industry ignores this. The Cost of Ignoring Culture: Groundbreaking insights from Tanya Luhrmann, Arthur Kleinman, and WHO data showing why non-Western cultures often see better long-term outcomes for schizophrenia. Beyond the DSM: Breaking down the 8 layers of human suffering, predictive processing, HiTOP, RDoC, and Karl Friston's free energy principle. Why replacing the DSM with dimensional models will still fail if we strip away the human connection. The active variables of psychological work are inherently untrackable. The industry has spent 40 years pretending that only the measurable is real, paving the way for the cold efficiency of artificial intelligence. But the real healing continues anyway, transmitted hand-to-hand in the rooms where it has always lived. About the Host Joel Blackstock is a Licensed Independent Clinical Social Worker (LICSW), Clinical Supervisor, and the Clinical Director of Taproot Therapy Collective in Hoover, Alabama. He specializes in Brainspotting, Emotional Transformation Therapy, qEEG neurofeedback, Jungian psych, and somatic/depth approaches to trauma.

Donald Trump’s China trip brings America…. NADA. The U.S. Oil Blockade on Cuba brings Cubans a serious economic crisis, so what does the U.S. do? They send 100 million dollars in aid to Cuba,(on the crisis they created). CIA director John Radcliffe gives a TRUMP verbal demand that Fundamental Changes are needed in Cuba or Else. A New psychiatric medical diagnosis fitting for Donald Trump surfaces,(Joe Kent). Donald Trump is a….Malignant Narcissist. A Cancerous Personality that is growing…… Metastasizing. Not yet in the DSM-5, but it surely will be. Steve

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

What happens when you relate to parts of autism, ADHD, giftedness, sensory sensitivity, masking, and trauma, but never fully fit into one diagnosis or label? In this timely conversation, Dr. Marianne Miller sits down with neuro-affirming clinical psychologist Dr. Emma Offord to explore “neurohybridity,” a term Emma developed to describe the fluid, overlapping, and mosaic-like nature of neurodivergent identity. Together, they unpack why so many late-diagnosed autistic and ADHD adults, especially women and marginalized people, feel unseen by rigid diagnostic systems and traditional mental health models. This episode explores late-diagnosed autism, ADHD in adults, masking, giftedness, medically unexplained symptoms, trauma, neurodivergence in midlife, and the limitations of the DSM and medicalized language. Dr. Emma Offord shares how safety, environment, nervous system regulation, identity, and lived experience can shape how neurodivergent traits appear and why many people feel they do not fully belong within one category. If you have ever questioned whether you are “autistic enough,” “ADHD enough,” too emotional to be autistic, or too complicated for a single diagnosis, this conversation may help you feel seen in a completely different way. What Is Neurohybridity? Dr. Emma Offord describes neurohybridity as an invitation to move beyond rigid diagnostic boxes and recognize the dynamic nature of neurodivergent experience. Rather than viewing people through fixed categories, neurohybridity acknowledges that many individuals identify with multiple neurotypes, sensory experiences, cognitive styles, and ways of moving through the world. Marianne and Emma discuss how neurodivergent traits can shift depending on context, stress, environment, nervous system safety, masking, trauma, and support systems. They also explore how someone can feel sensory-seeking in one moment and sensory-avoidant in another, emotionally expressive yet highly masked, or deeply connected to multiple neurodivergent identities at once. The conversation also examines how many people become trapped between diagnostic categories and how current systems often fail individuals whose experiences do not fit neatly into one lane. Late-Diagnosed Autism, ADHD, & Misdiagnosis Many neurodivergent adults grow up feeling different without having language for their experiences. Dr. Emma Offord shares how traveling extensively as a child, experiencing grief and loss, and later discovering neurodivergence shaped her understanding of identity and belonging. Marianne and Emma discuss how outdated autism and ADHD stereotypes continue to affect diagnosis, especially for women, emotionally expressive people, and those who have spent years masking. They also explore how traditional diagnostic models can overlook the complexity of lived experience, particularly for people who move between different neurodivergent presentations over time. This episode speaks directly to people who have felt misdiagnosed, unseen, invalidated, or confused by rigid definitions of neurodivergence. The Limits of the Medical Model Marianne and Emma also explore the emotional and systemic consequences of reducing people to diagnostic checklists and symptom categories. They discuss how diagnosis can simultaneously provide access to protection, accommodations, and community while also limiting how people understand themselves. The conversation touches on medical trauma, medically unexplained symptoms, intersectionality, research bias, and the ways historically marginalized groups are often excluded from dominant mental health narratives. Together, they explore the need for more collaborative, flexible, neurodivergent-affirming systems of care that allow people to exist beyond narrow definitions. About Dr. Emma Offord Dr. Emma Offord is a neuro-affirming clinical psychologist, coach, speaker, and founder of Divergent Life. Her work focuses on neurodivergence, masking, trauma-informed care, relational safety, identity, and the lived experience of late-discovered neurodivergence. Emma developed the concept of neurohybridity to describe the fluid, dynamic, and interconnected nature of neurodivergent identity. She is currently writing a book exploring these ideas and amplifying the voices of people who have felt unseen or misunderstood within traditional diagnostic systems. Connect With Dr. Emma Offord You can connect with Dr. Emma Offord on Instagram at @divergentlives, through the Divergent Life website, and through This Voice Is Mine: The Unquiet Podcast. Related Episodes With Dr. Emma Offord and on Neurodivergent Needs and Experiences Unmasking, Embodiment, & Trust: A Neurodivergent Approach to Eating Disorder Recovery With Dr. Emma Offord @divergentlives on Apple & Spotify. Why Eating Still Breaks Down for Neurodivergent People With Long-Term Eating Disorders on Apple & Spotify. Unmasking in Eating Disorder Recovery: What Neurodivergent People Need to Know About Safety & Healing via Apple & Spotify. Autism & Anorexia: When Masking Looks Like Restriction, & Recovery Feels Unsafe via Apple & Spotify. Recovering Again: Navigating Eating Disorders After a Late Neurodivergent Diagnosis (Part 1) With Stacie Fanelli, LCSW @edadhd_therapist via Apple & Spotify. Work With Dr. Marianne Dr. Marianne Miller is an eating disorder therapist and LMFT specializing in ARFID, binge eating disorder, autism, ADHD, neurodivergence, and eating disorder recovery. She offers therapy services for clients in California, Washington, D.C., and globally through coaching support. For therapy, coaching, podcast episodes, courses, and other resources, visit Dr. Marianne's website and follow along on Instagram @drmariannemiller.

Why do so many people know what to eat… but still can't follow through? In this episode, Dr. Brendan McCarthy breaks down the powerful connection between trauma, stress, and ultra-processed foods—and why willpower alone is not enough. You'll learn how the nervous system, PTSD, and chronic stress can rewire your relationship with food, driving cravings and behaviors that feel out of your control. This isn't about discipline. It's about understanding the biology behind your choices. Inside this episode: How trauma changes the way you make decisions Why ultra-processed foods create temporary emotional relief The brain chemistry behind cravings (dopamine, serotonin, endocannabinoids & more) Why “just stop eating it” doesn't work How to create real change without shame or restriction If you've ever felt stuck in a cycle with food, this episode will change how you see it—and give you a path forward.

What if you mental health struggles were something more than what the DSM identifies? What if there was a spiritual aspect keeping you from walking in freedom?Dr. Natalie Atwell has spent over 20 years as a licensed therapist, and she'll be the first to tell you she ignored that question for most of her career. Then the cases got darker, standard treatments stopped working, and a deep dive into Dr. Michael Heiser's divine council worldview changed how she reads both her Bible and her intake forms.There's a quiet crisis happening inside Christian counseling offices. Clients are arriving with presentations - dissociation, compulsive sexual behavior, debilitating anxiety, sleep paralysis - that don't resolve the way they should. The DSM has no category for what some of these people are experiencing. And the therapists treating them are quietly asking a question they're not sure they're allowed to ask: Is something spiritual going on here?Dr. Atwell says yes, and she's built a clinical framework to navigate it. Drawing on the Deuteronomy 32 worldview and Dr. Michael Heiser's understanding of the three rebellions of Genesis 3, 6, and 11, she maps categories of mental health suffering back to specific entry points of spiritual darkness. It's a careful, clinically-informed attempt to take Ephesians 6:12 seriously in a treatment room.The demand in the broader body of Christ is real. Pastors are referring people to therapists because they don't have a framework. Therapists are getting stuck because they don't have the theology. Dr. Atwell's work, including her assessment tool that asks about Ouija boards, occult involvement, and even alien abduction experiences, is an attempt to build a bridge between those two worlds. Not to replace either one, but to help clinicians ask better questions.0:00 – Introduction1:25 – Dr. Natalie Atwell3:58 – Satanic Ritual Abuse7:01 – Counselor's Awakening9:35 – Darkness Uptick Explained17:01 – Divine Council Worldview25:21 – Oppression vs. Possession29:07 – Three Categories Framework37:31 – Deliverance Treatment Model40:06 – Other Influences Assessment47:58 – Client Case Study54:36 – Mental Warrior ConsultingABOUT THE GUEST:

Amidst a long catalog of previous BFTA stories featuring complex or developmental PTSD, today's story is one of classic DSM-style PTSD, it's a story of both medical and parenting trauma, of facing the fear of annihilation and death. In this three part story,  first we hear Tracy tell of the increasingly severe medical challenges of her children, then Tracy flashes back to describe her own terrifying emergency hospitalization as a 5 year old, then finally we trace Tracy's treatment journey through traditional psychotherapy and eventual MDMA-assisted therapy as she tries to find a way to calm her nervous system and find peace.Support the show! https://www.buzzsprout.com/396871/supportBringing Therapy into Med Management-- An intensive workshop for psych NPs and PAs, June 3-6 2026 in Ft Collinshttps://www.craigheacockmd.com/bringing-therapy-into-med-management/"I Love You, I Hate You, Are You My Mom?"  An intensive experiential workshop exploring transference and countertransference with Dr. H and Dr. Hillary McBride, June 18-20 2026 in Vancouver/Chilliwack BChttps://www.craigheacockmd.com/i-love-you-i-hate-you-are-you-my-mom/Explore every episode through themes, domains, formats, and speakers. The BFTA CODEX is a listener-built and curated field guide to the podcast. https://bfta-codex.orgBFTA episode recommendations/Podcast pagehttps://www.craigheacockmd.com/podcast-page/BFTA on IG @backfromtheabysspodcasthttps://www.instagram.com/backfromtheabysspodcast/Support the show

When musician Chris Dowd was 19, shortly after graduating from high school, his band Fishbone got signed to Columbia Records. The group was made up of Black teenagers in Los Angeles, who combined several musical genres—funk, punk, ska, metal, reggae—into a new exciting sound in the late 70's. They influenced countless other bands but struggled to find lasting commercial success.This week on the show, Chris talks to Anna Sale about being a teenage rock pioneer who stepped away from the group in 1994. He also discusses his close friendship with the late Jeff Buckley, his trouble with alcoholism after Jeff's death, and what it's been like to rejoin Fishbone and go on tour. Fishbone songs featured in this episode:Skankin' to the BeatUglyAdolescent Regressive BehaviorParty at Ground Zero CubicleLove is LoveLast Call in America (feat. George Clinton) HouseworkWatch Fishbone's 1991 performance on SNL: https://www.dailymotion.com/video/xl7e88 This episode was produced by Cameron Drews and Daisy Rosario. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

When musician Chris Dowd was 19, shortly after graduating from high school, his band Fishbone got signed to Columbia Records. The group was made up of Black teenagers in Los Angeles, who combined several musical genres—funk, punk, ska, metal, reggae—into a new exciting sound in the late 70's. They influenced countless other bands but struggled to find lasting commercial success.This week on the show, Chris talks to Anna Sale about being a teenage rock pioneer who stepped away from the group in 1994. He also discusses his close friendship with the late Jeff Buckley, his trouble with alcoholism after Jeff's death, and what it's been like to rejoin Fishbone and go on tour. Fishbone songs featured in this episode:Skankin' to the BeatUglyAdolescent Regressive BehaviorParty at Ground Zero CubicleLove is LoveLast Call in America (feat. George Clinton) HouseworkWatch Fishbone's 1991 performance on SNL: https://www.dailymotion.com/video/xl7e88 This episode was produced by Cameron Drews and Daisy Rosario. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

When musician Chris Dowd was 19, shortly after graduating from high school, his band Fishbone got signed to Columbia Records. The group was made up of Black teenagers in Los Angeles, who combined several musical genres—funk, punk, ska, metal, reggae—into a new exciting sound in the late 70's. They influenced countless other bands but struggled to find lasting commercial success.This week on the show, Chris talks to Anna Sale about being a teenage rock pioneer who stepped away from the group in 1994. He also discusses his close friendship with the late Jeff Buckley, his trouble with alcoholism after Jeff's death, and what it's been like to rejoin Fishbone and go on tour. Fishbone songs featured in this episode:Skankin' to the BeatUglyAdolescent Regressive BehaviorParty at Ground Zero CubicleLove is LoveLast Call in America (feat. George Clinton) HouseworkWatch Fishbone's 1991 performance on SNL: https://www.dailymotion.com/video/xl7e88 This episode was produced by Cameron Drews and Daisy Rosario. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

A child's diagnosis can feel like a lifeline and a weight at the same time. When your child struggles with attention, learning, anxiety, behavior, or social connection, the question isn't only “What is it?” It's also “What will a diagnosis change for my child, for school, for insurance, and for how they see themselves?” On this episode of The Brainy Moms Podcast, Dr. Amy is joined by pediatric neuropsychologist Dr. Rebecca “Dr. F” Fontanetta to talk through why diagnoses like ADHD, autism spectrum disorder, dyslexia, anxiety disorders, Tourette syndrome, ARFID, and developmental coordination disorder often overlap. Dr. F explains why the DSM shifted to allow more co-occurring diagnoses, how that can improve access to the right services, and why the real value is usually the full neuropsychological evaluation report that links test data to everyday life. We also dig into the “overpathologizing” trap, what a meaningful change from baseline looks like, and when a wait-and-see approach is reasonable versus risky. You'll hear practical guidance for public school and homeschool families, including how IEP and 504 accommodations work, why insurance reimbursement often drives the need for formal documentation, and how to choose the right clinician for your child's age and needs. We close with a reminder that no word on paper changes who your child is, and that understanding barriers and building support matters more than chasing the perfect label.Subscribe for more parenting and learning science, share this conversation with a friend who's wrestling with testing, and leave a review telling us: what's the hardest part of deciding whether to seek a diagnosis?ABOUT US:The Brainy Moms is a parenting podcast hosted by cognitive psychologist Dr. Amy Moore and Sandy Zamalis. Dr. Amy and Sandy have conversations with experts in parenting, child development, education, homeschooling, psychology, mental health, and neuroscience. Listeners leave with tips and advice for helping parents and kids thrive. If you love us, add us to your playlist and follow us on social media! CONNECT WITH US:Website: www.TheBrainyMoms.com Email: BrainyMoms@gmail.com Social Media: @TheBrainyMomsSubscribe to our free monthly newsletterVisit our sponsor's website: www.LearningRx.com

If your child has been diagnosed with ADHD, stimulant medication is probably the first thing their doctor mentioned. And if you're trying to figure out whether it's the right choice for your family, you deserve more than a pamphlet published by a drug company. You deserve the full picture - including what the research really shows, who funded it, and the questions the medical model of ADHD hasn't answered. The story most parents get is a tidy one: ADHD is a chronic brain disorder, it's highly heritable, and stimulant medication is the most effective treatment. That story comes mostly from one very influential researcher, Dr. Russell Barkley, and it has shaped how millions of families make medication decisions.  But when you look closely, cracks start to appear - in the diagnostic criteria, in the science, and in the financial ties between the researchers who built the medical model and the pharmaceutical companies that profit from it. Questions this episode will answer What are the DSM-5 criteria for diagnosing ADHD? The DSM-5 requires children to show at least 6 symptoms (5 for adults) that appear "often" across multiple settings. But who decides how often is "often" - and whether a behavior is "inappropriate" - turns out to be deeply shaped by cultural values, not objective measurement. Why are ADHD diagnoses increasing? Research shows that school accountability policies like No Child Left Behind drove significant increases in ADHD diagnoses, particularly among low-income children. In some states, diagnosing a child with ADHD could raise a school's average test scores - creating a financial incentive that had nothing to do with the child's actual needs. What is Russell Barkley's theory of ADHD? Barkley sees ADHD as a chronic, highly heritable brain disorder rooted in deficits in executive functioning. He compares it to diabetes: a lifelong condition requiring ongoing treatment, primarily with stimulant medication. This episode examines both his framework and the places where his own research contradicts itself. Is ADHD overdiagnosed? The evidence suggests yes, in many cases. Diagnosis rates vary by a factor of two to three across U.S. states when there aren't consistent biological or cultural differences between these states. Many children receive a diagnosis after a 15-minute pediatric visit, not the thorough multi-source evaluation the research actually recommends. Is ADHD neurodivergent? Yes - and that framing shapes how a child with ADHD gets supported. The medical model treats ADHD as a brain disorder: something broken that medication needs to fix. A neuroaffirming approach treats it as a difference - and asks whether the environment, not just the child, needs to change. The diagnostic criteria themselves embed specific cultural values about what counts as "appropriate" behavior. Whether your child gets treated as disordered or different depends entirely on which framework their clinician is working from. What is actually happening in an ADHD brain? Barkley frames ADHD as a deficit in executive functioning - the brain systems that regulate attention, impulse control, and behavior over time. But the research on whether stimulant medication repairs that brain development is contradictory, and Barkley himself makes both claims in different videos. What are the benefits of ADHD medication? Stimulant medication does improve attention and reduce motor activity in the short term - but it does this in everyone's brain, not just in people with ADHD. This episode looks at what medication actually does, what it doesn't do, and what the drug company advertising left out. What you'll learn in this episode Why the word "often" in every single DSM-5 ADHD criterion creates a diagnosis that depends heavily on who is observing the child - and what cultural standards they're applyingHow the same behaviors in children in Hong Kong were rated far more severely than those of children in the U.K., and what that tells us about what ADHD is actually measuringThe financial relationships between the most influential ADHD researchers - including Barkley and Dr. Joseph Biederman - and the pharmaceutical companies that make ADHD medicationsWhy ADHD diagnosis rates in states like North Carolina and Ohio run two to three times higher than in California and Nevada, and what school accountability policies have to do with itThe contradiction at the heart of Barkley's medical model: if stimulant medication promotes brain development, why does he say it must be taken for life?How drug company ads used Barkley's and Biederman's research to frighten parents into medicating their children - and the FDA's ineffective responseWhy the scary outcome statistics Barkley cites - including a reduced life expectancy of up to 13 years - don't tell us much about outcomes for real people with ADHDWhat a neuroaffirming approach to ADHD looks like, and why this episode argues that the most important question isn't how to change the child to fit the environment - it's whether the environment fits the child Click here to download the infographic: What You've Been Told About ADHD vs. What the Research Actually Shows Jump to highlights: 01:14 Jen introduces a three-episode arc examining the medical model of ADHD, which positions it as a chronic, highly heritable brain disorder. This first episode covers what ADHD is according to leading researcher Dr. Russell Barkley, how it's diagnosed, problems with diagnosis, and financial conflicts of interest. 06:37 Kids need six out of nine symptoms, adults need five. Each symptom must occur "often" - but there's no objective measure for what "often" means. 10:10 Dr. Barkley sees ADHD as a deficit in executive functioning - the ability to self-regulate over time. It breaks down into inhibition (hyperactive-impulsive behavior) and metacognition (inattention symptoms, which he says are misnamed). 12:37 Dr. Barkley compares ADHD to diabetes, saying it's a chronic condition needing ongoing treatment. Just like you wouldn't expect insulin to cure diabetes, he argues, you shouldn't expect ADHD medication to fix someone's brain so they can stop taking it. 23:30 Barkley says parents might have legitimate reasons for "non-compliance" with training, like family stress. Training may be discontinued while stress is managed. But kids who don't comply get behavior modification - no understanding or flexibility for them. 30:45 Barkley has essentially created a new diagnostic category called Sluggish Cognitive Tempo (marked by daydreaming, lethargy, slowed thinking) even though it's never been recognized by the Psychiatric Association. 35:44 Barkley presents data showing males with ADHD have a life expectancy 6.8 years less than the general population, females 8.6 years less. That's on par with smoking. Outcomes include lower education and income, more substance use, higher suicide rates (three times higher), more accidents, higher obesity and diabetes rates, and higher cardiovascular disease. 43:01 Wrapping up the discussion

You could not think your way out of the pattern. That is not a failure of insight. That is the nature of complex trauma. In this episode, Jennifer Wallace and Elisabeth Kristof return to one of the most resonant threads in Trauma Rewired's history: complex post-traumatic stress. Several years ago they recorded a series on CPT that changed how thousands of listeners understood themselves. This is the revision. Not a replacement of what came before, but a deepening, one shaped by advances in trauma research, neuroscience, and by the hosts' own continued growth. The reframe at the center of this episode is one that matters: complex trauma is not a disorder. It is not something wrong with you. It is a predictive nervous system pattern, an intelligent set of adaptations shaped by prolonged relational stress, often beginning in childhood, that made complete sense in the environment they were formed in. The question is not what is wrong with you. The question is what did your nervous system learn and how can it learn something new? Elisabeth and Jennifer trace the history of CPT as a clinical concept, from Judith Hermann's early naming of what PTSD could not capture, through Pete Walker's lived experience framework, into the current neuroscience of predictive patterning, interoception, and the body as the site of both the wound and the healing. They explain why complex trauma has no single memory to point to, why it often lives in sensation and state rather than narrative, and why that means healing looks different here than it does for single-event trauma. The episode also goes deep on something that does not get named enough in healing spaces: the trap of the healing vortex. The way that understanding complex trauma can become its own form of nervous system activation, another thing to fix, another layer to excavate, another reason the system cannot rest. Real growth, they argue, requires repetition and safety and time, but it also requires rest, play, and the gradual experience of being okay in the present moment without urgency. This episode opens the new CPT series and previews what is coming: the inner critic, toxic shame, social anxiety, emotional flashbacks, and self-abandonment, each explored not as pathology but as nervous system strategies that once served a purpose and can now be worked with differently. In This Episode, You Will Learn: Why complex trauma is better understood as a predictive nervous system pattern than a disorder The difference between CPT and PTSD and why that distinction matters for healing Why there is often no single memory in complex trauma, and why the experience lives in the body instead How interoception becomes disrupted in the context of chronic relational stress Why the nervous system seeks familiar environments, even harmful ones, and how that perpetuates the cycle How systemic and cultural trauma shapes the nervous system in the same way interpersonal trauma does What neuroplasticity actually requires: repetition, safety, and time, not insight alone Why pushing too hard into somatic work can backfire, and what pacing actually looks like How the healing vortex keeps people stuck and what stepping out of it makes possible What observer capacity is, why it is one of the most important markers of growth, and how it develops A preview of the five distinguishing characteristics of CPT that will be explored throughout the series     Chapter Markers 0:00 - CPT Shows Up Most Clearly in Relationships 1:13 - Welcome: Revisiting the Complex Trauma Series 2:04 - Why We Are Updating This Framework Now 4:25 - What Complex Trauma Is and Where the Term Came From 6:19 - Judith Hermann, Pete Walker, and Why This Language Matters 7:15 - Why We Use CPT Instead of CPTSD 8:07 - The Distinguishing Patterns: How Complex Trauma Shows Up 10:16 - DSM vs ICD-11: The Diagnosis Question 11:38 - CPT vs PTSD: Different Patterns, Different Healing 13:08 - When There Is No Memory: Implicit Patterning and the Developing Brain 15:20 - CPT as a Predictive Nervous System Pattern 17:09 - The Five Distinguishing Characteristics of CPT 18:07 - Trauma Lives in the Body, Not Just the Story 20:56 - Complex Trauma Is Fundamentally Relational 22:21 - Re-Patterning Secure Attachment Through Somatics 26:35 - Embodied Presence as the Foundation 29:55 - Systemic and Cultural Trauma: This Is Not Only Individual 34:24 - Pacing, Rest, and the Healing Vortex 37:24 - The Role of Play and Pleasure in Nervous System Re-Patterning 41:18 - Building Observer Capacity: The Shift From This Is Who I Am to This Is Happening in Me 43:22 - What Is Coming in the Rest of the CPT Series   Resources and Links NSI Foundations Bundle for coaches and practitioners: neurosomaticintelligence.com/foundations Two week Rewire Trial of guided neuro somatic training: rewiretrial.com Learn more about Elisabeth's work at brainbased.com Learn more about Jennifer's work at her YouTube channel: Sacred Synapse https://www.youtube.com/@sacredsynapse-23 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  

Send us Fan MailDr. Emily Wassmer, researcher at Children's Hospital of Philadelphia, presents findings from one of the first studies to examine gaming addiction in young children ages 5 to 12 with ADHD diagnoses. Using a newly developed caregiver-report screening tool based on DSM-5 criteria for internet gaming disorder, she found that inattention — more than hyperactivity, anxiety, depression, or autism symptoms — was the factor most strongly associated with meeting criteria for gaming addiction, mirroring patterns seen in adolescent research. Perhaps most striking was the parenting finding: each additional negative parenting behavior, such as yelling or losing one's temper, tripled the child's risk of gaming addiction — suggesting that evidence-based parent training programs already used in ADHD populations may be one of the most promising avenues for intervention.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

In this episode, I welcome back Mia Hughes — director of Genspect Canada, senior fellow at the Macdonald-Laurier Institute, and one of the sharpest writers on the gender scandal — to dig into the framework she calls "trans as an extreme overvalued belief." Mia walks us through the history of the overvalued idea, from Carl Wernicke in 1892 to Paul McHugh's post-9/11 application of the concept to ideologically driven violence, and explains why this psychiatric category — sitting between delusion and obsession — finally makes sense of the trans phenomenon in a way no other diagnosis ever has.We trace the Dutch origins of medical transition in the 1970s, the moment psychiatry "gave up" on these patients, and how WPATH's 2010 de-psychopathologization statement re-engineered a mental illness into a celebrated identity — triggering, in Mia's view, the social contagion that followed. I bring my clinical lens to the conversation, exploring transference and countertransference, neuroplasticity, the hijacking of dopamine through "gender euphoria," and why so many therapists get this wrong in both directions. We close on Mia's anorexia parallel and what it teaches us about loosening the grip of a pathological belief — gently, indirectly, and without the parent in the line of fire.Mia Hughes specializes in researching pediatric gender medicine, psychiatric epidemics, social contagion and the intersection of trans rights and women's rights. She is the author of The WPATH Files, a senior fellow at the Macdonald-Laurier Institute and director of Genspect Canada. She co-hosts the Beyond Gender podcast with Stella O'Malley and Bret Alderman, available on Apple, Spotify, and YouTube. Follow her on X @_CryMiaRiver. Follow her Substack @CryMiaRiver. Mia first appeared on this podcast in episode 107. Exposing Gender Malpractice: Mia Hughes on the WPATH Files, Medical Ethics, & Informed Consent. Books mentioned in this episode:• The Extreme Overvalued Belief by Tahir Rahman• Good Girls: A Study and Story of Anorexia by Hadley Freeman[00:00:00] Start[00:02:13] Trans as an Extreme Overvalued Belief[00:07:13] From 9/11 to Anders Breivik[00:11:13] Neuroplasticity and Adolescent Meaning-Making[00:18:52] Defining the Trans Overvalued Belief[00:22:52] The Dutch 1970s: When Psychiatry Gave Up[00:31:00] Countertransference and the Therapist's Role[00:38:35] WPATH's Fortress and the True Believer[00:43:20] Re-Psychopathologization Campaign[00:45:45] How HBIGDA Became WPATH[00:50:13] DSM-5, ICD-11 and the Sleight of Hand[01:02:08] Hacking Dopamine and Gender Euphoria[01:06:27] The Anorexia Parallel[01:13:13] What Therapists Get Wrong[01:28:45] Putting Cracks in the Belief[01:35:26] Helping the Part That Wants OutROGD REPAIR Course + Community gives concerned parents instant access to over 120 lessons providing the psychological insights and communication tools you need to get through to your kid. Now featuring 24/7 personalized AI support implementing the tools with RepairBot! Use code SOMETHERAPIST2026 to take 50% off your first month.PODCOURSES: use code SOMETHERAPIST at LisaMustard.com/PodCoursesPRODUCTION: Looking for your own podcast producer? Visit PodsByNick.com and mention my podcast for 20% off your initial services.MUSIC: Thanks to Joey Pecoraro for our song, “Half Awake,” used with gratitude & permission. ALL OTHER LINKS HERE. To support this show, please leave a rating & review on Apple, Spotify, or wherever you get your podcasts. Subscribe, like, comment & share via my YouTube channel. Or recommend this to a friend!Learn more about Do No Harm.Take $200 off your EightSleep Pod Pro Cover with code SOMETHERAPIST at EightSleep.com.Take 20% off all superfood beverages with code SOMETHERAPIST at Organifi.Check out my shop for book recommendations + wellness products.Show notes & transcript provided with the help of SwellAI.Special thanks to Joey Pecoraro for our theme song, “Half Awake,” used with gratitude and permission.Watch NO WAY BACK: The Reality of Gender-Affirming Care (our medical ethics documentary, formerly known as Affirmation Generation). Stream the film or purchase a DVD. Use code SOMETHERAPIST to take 20% off your order. Follow us on X @2022affirmation or Instagram at @affirmationgeneration.Have a question for me? Looking to go deeper and discuss these ideas with other listeners? Join my Locals community! Members get to ask questions I will respond to in exclusive, members-only livestreams, post questions for upcoming guests to answer, plus other perks TBD. ★ Support this podcast on Patreon ★

The comedy queen of our generation Nikki Glaser is on the pod today!! Not only is she hilarious and gorgeous, but extremely smart and compassionate and a phenomenal talker. We talk all things back pain, depression, sex, and our time together at the Vanity Fair Party. It's a good one enjoy!! Watch her new Hulu comedy special “Good Girl” on Hulu 4/24!! Fibromyalgia quote mentioned source: Wolfe, Walitt, Katz, and Häuser. “Symptoms, the Nature of Fibromyalgia, and Diagnostic and Statistical Manual 5 (DSM-5). Defined Mental Illness in Patients with Rheumatoid Arthritis and Fibromyalgia Website: https://pmc.ncbi.nlm.nih.gov/articles/PMC3925165/ Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr Kirk Honda and Dr Michael Drane explain the distinction between dissociative disorders and the problems with DSM. April 22, 2026This episode is sponsored by BetterHelp. Give online therapy a try at betterhelp.com/KIRK to get 10% off your first month.Support us by... Become a member: https://www.youtube.com/channel/UCOUZWV1DRtHtpP2H48S7iiw/joinBecome a patron: https://www.patreon.com/PsychologyInSeattleContact us/more info... Email: https://www.psychologyinseattle.com/contactAbout Dr. Kirk: https://www.psychologyinseattle.com/about-dr-kirk-hondaWebsite: https://www.psychologyinseattle.comGet stuff... Merch: https://psychologyinseattle-shop.fourthwall.com/KIRKgram (like Cameo): https://www.psychologyinseattle.com/kirkgramThe Psychology In Seattle Podcast ®Trigger Warning: This episode may include topics such as assault, trauma, and discrimination. If necessary, listeners are encouraged to refrain from listening and care for their safety and well-being. Disclaimer: The content provided is for educational, informational, and entertainment purposes only. Nothing here constitutes personal or professional consultation, therapy, diagnosis, or creates a counselor-client relationship. Topics discussed may generate differing points of view. If you participate (by being a guest, submitting a question, or commenting) you must do so with the knowledge that we cannot control reactions or responses from others, which may not agree with you or feel unfair. Your participation on this site is at your own risk, accepting full responsibility for any liability or harm that may result. Anything you write here may be used for discussion or endorsement of the podcast. Opinions and views expressed by the host and guest hosts are personal views. Although we take precautions and fact check, they should not be considered facts and the opinions may change. Opinions posted by participants (such as comments) are not those of the hosts. Readers should not rely on any information found here and should perform due diligence before taking any action. For a more extensive description of factors for you to consider, please see www.psychologyinseattle.com

In 2008, travel writer Rick Steves thought the U.S. might be on the verge of war with Iran. So he took a TV crew there to document the people and places who might soon be at risk. “You should know people before you bomb them,” he told Anna Sale. In this episode, Rick talks about his multiple visits to Iran (the first was in 1978) and how travel in general can challenge our beliefs and broaden our perspectives. He also explains how he manages his money and why he gives so much of it away. You can find Rick's most recent book On the Hippie Trail: Istanbul to Kathmandu and the Making of a Travel Writer on his website.His 2009 TV special from Iran is available on YouTube. And here's NPR's story by Rebecca Rosman about Rick purchasing the hygiene center. This episode was produced by Cameron Drews. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

In 2008, travel writer Rick Steves thought the U.S. might be on the verge of war with Iran. So he took a TV crew there to document the people and places who might soon be at risk. “You should know people before you bomb them,” he told Anna Sale. In this episode, Rick talks about his multiple visits to Iran (the first was in 1978) and how travel in general can challenge our beliefs and broaden our perspectives. He also explains how he manages his money and why he gives so much of it away. You can find Rick's most recent book On the Hippie Trail: Istanbul to Kathmandu and the Making of a Travel Writer on his website.His 2009 TV special from Iran is available on YouTube. And here's NPR's story by Rebecca Rosman about Rick purchasing the hygiene center. This episode was produced by Cameron Drews. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

In 2008, travel writer Rick Steves thought the U.S. might be on the verge of war with Iran. So he took a TV crew there to document the people and places who might soon be at risk. “You should know people before you bomb them,” he told Anna Sale. In this episode, Rick talks about his multiple visits to Iran (the first was in 1978) and how travel in general can challenge our beliefs and broaden our perspectives. He also explains how he manages his money and why he gives so much of it away. You can find Rick's most recent book On the Hippie Trail: Istanbul to Kathmandu and the Making of a Travel Writer on his website.His 2009 TV special from Iran is available on YouTube. And here's NPR's story by Rebecca Rosman about Rick purchasing the hygiene center. This episode was produced by Cameron Drews. Get more Death, Sex & Money with Slate Plus! Join for exclusive bonus episodes of DSM and ad-free listening on all your favorite Slate podcasts. Subscribe from the Death, Sex & Money show page on Apple Podcasts or Spotify. Or, visit slate.com/dsmplus to get access wherever you listen.If you're new to the show, welcome. We're so glad you're here. Find us and follow us on Instagram and you can find Anna's newsletter at annasale.substack.com. Our email address, where you can reach us with voice memos, pep talks, questions, critiques, is deathsexmoney@slate.com. Hosted on Acast. See acast.com/privacy for more information.

Avoidant/Restrictive Food Intake Disorder (ARFID) is an eating disorder diagnosis characterized by a persistent restriction or avoidance of food intake that results in clinically significant consequences (medical, nutritional, and/or psychosocial), but without the weight- and shape-driven psychopathology typical of anorexia nervosa and bulimia nervosa. In this episode, Megan Hellner and Katherine Hill outline how ARFID presents across the lifespan, why it is frequently missed in routine healthcare, and what an evidence-informed assessment and treatment pathway can look like in practice. A central theme is that ARFID is not synonymous with "picky eating" and not confined to any one body size. Patients may present at any point on the weight chart, including those who are weight-stable or in larger bodies, and the condition can begin in early childhood and persist into adulthood. The episode also highlights ARFID in athletes and physically active people, where restricted dietary variety and/or low intake can contribute to low energy availability and RED-S-like presentations, sometimes without an obvious intent to lose weight. Timestamps [03:48] Interview start [06:23] What is ARFID? DSM-5 definition vs "picky eating" [09:36] Clinical red flags: when restriction becomes a disorder [11:37] ARFID isn't always underweight: missed cases & diagnostic pitfalls [16:46] ARFID presentation profiles: low interest, sensory sensitivity, fear [18:59] Comorbidities & nutrition consequences [25:16] Evidence-based ARFID treatment [29:16] How to expand foods without pressure [32:28] Weight restoration, stabilization, and long-term maintenance [35:44] What research still needs [38:16] Differential diagnosis & referral Links/Resources Go to episode page (with links to papers and ARFID resources) Subscribe to Sigma Nutrition Premium Join the Sigma email newsletter for free Enroll in the next cohort of our Applied Nutrition Literacy course

In this conversation, Trent Horn and Kade Bradley go head-to-head on some of the hardest questions in modern sexual ethics: whether morality is grounded in natural law or human flourishing, whether affirmation actually improves outcomes, and whether data alone can settle moral debates. They also clash over same-sex relationships, public norms, schools, DSM history, transgender questions, and the limits of harm-based reasoning.

Struggling with treatment-resistant depression or trying to recover from narcissistic parents and a lost sense of identity? In this episode, Katie Morton, LMFT, explores advanced mental health treatments and provides a roadmap for healing from complicated family dynamics. Whether you are dealing with "sticky memories," navigating a schizoaffective disorder diagnosis, or looking for ways to manage the physical toll of trauma on your gut, this deep dive offers practical tools to help you reclaim your life. We also discuss the power of boundaries and the vital role sleep plays in regulating anxiety. Shopping with our sponsors helps support Ask Kati Anything. Please check out this week's special offers: • Magnesium promotes relaxation and more restful sleep - visit https://bioptimizers.com/kati for 15% off any order • Care.com: Get 20% off a subscription or a senior care advisor plan at https://www.care.com/ using code KATI Chapters 00:00:49 – Q1: Creating Perspective in Severe Depression A viewer struggling with autism and treatment-resistant depression asks how to find small moments to live for when every task feels like "climbing Mount Everest." 00:14:17 – Q2: Recovering Identity from Narcissistic Parents A child of divorce seeks advice on building a sense of self after growing up with a narcissistic mother and an emotionally unavailable father. 00:20:50 – Q2 Follow-up: Healing the "Parental Wound" Addressing a comment on parental isolation, Katie discusses inner child work and letting go of the idealized version of a parent. 00:26:12 – Q3: Understanding "Sticky Memories" A viewer asks if they are "mixing memories" regarding childhood abuse or if their brain is signaling something real that needs processing. 00:29:24 – Q4: What is Projective Identification? How to stop taking on other people's intense emotions and use "inward boundaries" to protect your own mental space. 00:35:24 – Q5: Navigating a Schizoaffective Diagnosis Katie breaks down the DSM criteria for schizoaffective disorder, explaining the intersection of mood disorders and psychosis. 00:40:38 – Q6: The Connection Between Trauma and the Gut An exploration of the "gut-brain axis" and how chronic stress and high cortisol can lead to physical abdominal issues. 00:45:11 – Q7: Why Sleep is Essential for Anxiety Relief A discussion on how sleep "cleans" the brain and provides the emotional regulation needed to weather life's storms. SchizoKitzo (tiktoker mentioned in episode) https://www.tiktok.com/@schizokitzo?is_from_webapp=1&sender_device=pc Ask Kati Anything ep. 310 | Your mental health podcast, with Kati Morton, LMFT Books Why Do I Keep Doing This? https://geni.us/XoyLSQ Traumatized https://geni.us/Bfak0j Are u ok? https://geni.us/sva4iUY ONLINE THERAPY (enjoy 10% off your first month) While I do not currently offer online therapy, BetterHelp can connect you with a licensed, online therapist: https://betterhelp.com/kati PARTNERSHIPS Nick Freeman | nick@biglittlemedia.co Disclaimer: The information provided in this video is for educational and informational purposes only and is not intended as medical or mental health advice. It should not be used to diagnose or treat any health problem or disease. Always consult with a qualified healthcare professional for diagnosis and treatment. Viewing this content does not establish a therapist-client relationship. #podcast #psychology #katimorton Learn more about your ad choices. Visit megaphone.fm/adchoices

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