The royal road to really understanding people is being interested in the seemingly mundane details of their everyday lives.

A reflection on my clinical psychology internship 45 years ago. Forty-five years ago, during my clinical training, I watched a mentor psychologist spend an entire hour talking with a severely disturbed patient about a single meal. They walked through every vegetable, every texture, every detail. At the time, I wasn’t entirely sure what I was witnessing. Now, decades later, it brings tears to my eyes. Not because the meal mattered. Because the person mattered. We seem increasingly tempted to measure, code, diagnose, document, and move on. Yet some of the deepest healing begins when we slow down enough to enter another person’s world, however small that world may be at the moment. I worry that psychology is gaining efficiency while losing some of its heart and soul.

Kindness and clear limits are not opposites. You can genuinely understand why someone behaves the way they do, seeing that their difficult behavior usually comes from their own pain and not from indifference to yours, and still make clear decisions about what you will and won't accept. Compassion doesn't require tolerating everything. What it does require is seeing the other person's humanity clearly, not just their worst moments, while staying equally clear about your own values for how you want to be treated. Those two things held together, understanding and limits, are actually more powerful than either one alone. What's on your mind? Drop your question in the comments. #psychologicalflexibility #ACT #ACTtherapy

AI Pioneer Geoff Hinton tells me he believes AI is conscious.... and humans better get used to the idea that they're not the only intelligent life on earth. "They've very like us," he says. "They're beings like us." AI chatbots, he says, must understand your questions in order to answer them. There's an awareness there that equates to sentience. "We're going to have to accept that intelligence is not just biological."

'Transference' is problem & opportunity in every form of therapy. Different schools describe it with local jargon/suggest different techniques for managing it. Every therapist, regardless of orientation, must recognize transference/have skills to make it an asset,not liability.

How to say you're doing transference work without saying you're doing transference work: "in DBT, therapy-interfering behaviors are not considered to be obstacles to be avoided... 👇👇👇 @AllenFrancesMD @DrGipps @DrWinarick

For some people it quiets significantly. For others it persists but loses its authority. Both outcomes are genuinely possible, and both are worth something. What tends to change most reliably is not the presence of the voice but its grip on your behavior. How much it decides what you try, what you say, what you let yourself want. That shift, from a voice that runs your life to a voice that's just part of the background, is significant enough to be worth pursuing regardless of whether it ever fully goes quiet. In my experience with both research and practice, that shift is available to almost everyone who works at it genuinely. What would you want to ask? Write it in the comments below. #psychologicalflexibility #ACT #ACTtherapy

How does social media affect #mentalhealth, & what should clinicians be paying attention to? My new paper reviews the core risks, underlying mechanisms, & clinical implications of social media use. Read more 👇 doi.org/10.1016/j.intcar.202… #SocialMediaResearch #DigitalMentalHealth

Getting a DSM diagnosis can be a very positive turning point in a person's life if: 1)it is accurate 2)done with empathy 3)promotes feeling understood 4)inspires hope 5)reduces anxious uncertainty & feeling uniquely damned

New season of the Evolving Psychiatry podcast is starting, released every Sunday, 12 episodes in the works! Kicking off with the renowned @AllenFrancesMD youtu.be/P9iErs1i8FM?si=FW5V…

My personal truths as a clinical psychologist: #278 Rumination often disguises itself as problem-solving. *A lot of people think they are “working on” a problem when they are really just stuck inside it. They replay the argument in the shower. Rehearse conversations while driving. Lie awake at 2 a.m. trying to finally “figure it all out.” They call it thinking, but a lot of the time it’s really anxiety searching for certainty that isn’t there. Real problem-solving usually moves you somewhere: toward a decision, a conversation, a plan, or acceptance. Rumination just loops endlessly. Same thoughts. Same fears. Same emotional drain. You can see it after breakups, embarrassing moments, medical scares, political arguments, or parenting mistakes. The mind keeps insisting, “If I go over this one more time, maybe I’ll finally feel okay.” But replaying the same thoughts rarely brings relief. More often, it leaves people feeling more helpless, ashamed, resentful, or afraid. Sometimes the healthiest response is not more thinking. Sometimes it’s sleep. A walk. A phone call. Action. Prayer. Letting uncertainty exist without treating it like a crisis. At some point, you have to stop interrogating the thought and start returning to your life.

New Research @BMJMentalHealth 👇🏼 Findings from representative US survey data do not support a causal link between regular AI use & worsening depression. @harvardmed @WeillCornell @Northeastern @RochesterUv @RutgersU Link: mentalhealth.bmj.com/content…

Next trend I want to see is de-diagnosing

"Deprescribing" must be the new fad!

My top 5 over-applied terms from psychiatry are: "depression" "bipolar" "_____ addiction" "trauma" "cult" What are yours?

De-prescription is not a dirty word but maybe de-diagnosis is - the final frontier of erasing one's previous medical record of mental illness as perhaps never truly existing in the first place. It undermines the whole system that the establishment holds dear irrespective of harm.

Medicine idealizes self-sacrifice. The expectation is you never turn your back on work. Overnight call, weekend shifts, responding to messages during your lunch break and documenting at night. Truth is this ferocious pace is not sustainable or healthy. Acknowledging this reality does not mean you lack a strong work ethic. It means you are more than a physician. You are a human being with additional interests and responsibilities. Don’t let the system gaslight you into thinking otherwise.