PhD/PsyD Just a thread to post the weirdest/whackiest/dumbest mental health-related stuff you come across in the (social) media...

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Today I encountered someone claiming to be a psychologist who stated that narcissism and, by extension, NPD, is just a variant of OCD.
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Yesterday on the r/therapists subreddit, there was a thread about things one has learned that have been formative/foundational to their practice (or massively changed one's thinking about practice), and several of the comments were some permutation of "everything is ultimately rooted in trauma." A lot of folks also mentioned reading Psychodynamic Diagnosis by Nancy McWilliams as mind-blowing (I don't think I have to give details on my negative opinions on this) and mentioned IFS as blowing their minds. People in this field really have a low bar for having their minds blown.
 
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EnPsychlopedia said:
Yesterday on the r/therapists subreddit, there was a thread about things one has learned that have been formative/foundational to their practice (or massively changed one's thinking about practice), and several of the comments were some permutation of "everything is ultimately rooted in trauma." A lot of also mentioned reading Psychodynamic Diagnosis by Nancy McWilliams as mind-blowing (I don't think I have to give details on my negative opinions on this) and mentioned IFS as blowing their minds. People in this field really have a low bar for having their minds blown.
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The smaller the mind, the less it takes to blow it.
 
PsyDr said:
What is the over/under on society returning back to recovered memories and Satanic Panic?
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Q-Anon is a modern manifestation of child sex trafficking panic. Child sex trafficking panic is relatively common even among folks who aren’t in Q-Anon or part of the MAGA cult. Just a few years ago there was that whole kerfuffle about Wayfair being a front for child sex trafficking, and the number of wild conspiracies which have arisen in the wake of the Epstein arrest and suicide have also branched into child (I don’t mean just mean teen girls and young women, but literal pre-pubescent children) sex trafficking panic.

I think that’s the modern permutation of the Satanic Panic. Now we just need an Elizabeth Loftus type figure to come around and slap some sense into everyone.
 
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EnPsychlopedia said:
Q-Anon is a modern manifestation of child sex trafficking panic. Child sex trafficking panic is relatively common even among folks who aren’t in Q-Anon or part of the MAGA cult. Just a few years ago there as that whole kerfuffle about Wayfair being a front for child sex trafficking, and the number wild conspiracies which have arisen in the wake of the Epstein arrest and suicide have also branched into child (I don’t mean just mean teen girls and young women, but literal pre-pubescent children) sex trafficking panic.

I think that’s the modern permutation of the Satanic Panic. Now we just need an Elizabeth Loftus type figure to come around and slap some sense into everyone.
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I mean given how bad they are at delivering furniture sometimes, it isn't the least plausible thing I have ever heard.
 
Met an old colleague of mine recently who started a private practice and she’s doing tarot readings as a service (like, during her sessions). When I suggested this was erm, perhaps not counseling as we are meant to practice it under our license, her rebuttal was that the Jungians do dream analysis and it’s basically the same.

Which, 1) it’s not really, because in dream analysis at least the patient gets to speak and process, and also 2) if Jungian analysis is the best equivalent you got, then….
 
chicandtoughness said:
Met an old colleague of mine recently who started a private practice and she’s doing tarot readings as a service (like, during her sessions). When I suggested this was erm, perhaps not counseling as we are meant to practice it under our license, her rebuttal was that the Jungians do dream analysis and it’s basically the same.

Which, 1) it’s not really, because in dream analysis at least the patient gets to speak and process, and also 2) if Jungian analysis is the best equivalent you got, then….
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My guess is that they've been influenced by this f***in' guy:

 
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R. Matey said:
My guess is that they've been influenced by this f***in' guy:

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Eclectic witchcraft has been popular for a while. There are several books on blending mental health/psychotherapy and witchcraft. I think one of the most popular ones is The Witch Wound. Then there was the super popular Shadow Work Journal that made the rounds in witchy circles before expanding to a more mainstream audience. Even in the VA, I had clients referencing it. I haven't seen the gentleman in the video, but he has a lot of competition in that space.

Yes, I'm chronically online.
 
Shiori said:
Eclectic witchcraft has been popular for a while. There are several books on blending mental health/psychotherapy and witchcraft. I think one of the most popular ones is The Witch Wound. Then there was the super popular Shadow Work Journal that made the rounds in witchy circles before expanding to a more mainstream audience. Even in the VA, I had clients referencing it. I haven't seen the gentleman in the video, but he has a lot of competition in that space.

Yes, I'm chronically online.
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Lol, gtk. I know Miller's been talking about this and a bunch of other related bs for decades. I saw him speak years ago and wrote him off as nuts, but I do try to keep tabs on developments.
 
EnPsychlopedia said:
Binet was not the progenitor of intelligence testing. Sure, he created the first modern "IQ test," but the roots of measuring human intelligence were around before he did that--Galton, notably. It would be very difficult to remove the original Binet from the historical context of eugenics and racism that served as the bedrock for most of modern statistical and psychometric practice--Galton and Fisher practically invented statistics as a means of testing their white supremacist hypotheses. Again, I recognize that there are nuances and am here actively defending the utility of IQ--but it's pretty solidly the case that the historical roots out of which it grew are firmly eugenicist.
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I cannot argue that many of the early researchers and thinkers about intelligence also had supportive views of eugenics. And likely many other views that do not match modern day thinking (and science).

Importantly, something had to influenced Galton before he proposed the concept of intelligence. From what I can tell, it was his cousin Darwin. I do not believe that Darwin had eugenicist thoughts when discussing evolution. At the end of the day, we can also say that intelligence is unambiguously rooted in the theory of evolution.

It also feels uneven to ignore all the important early IQ test developments (e.g., Binet, Wechsler, Army tests), which were not related to eugenics.

I guess it becomes an issue of verbiage. Unambiguously rooted, to me, sounds too extreme. To say that many of the earliest thinkers were interested in eugenics and intelligence and most of these ideas had been shed by the time IQ testing was beginning to be introduced to the world (Terman still stuck around with them), feels like a more accurate and balanced statement.

As often is the case, my gripe is with the verbiage rather than the ideas.

Interestingly, this article (Personal space: The religious origins of intelligence testing | BPS) posits that the views of early intelligence researchers and eugenics come from religion.
 
R. Matey said:
Lol, gtk. I know Miller's been talking about this and a bunch of other related bs for decades. I saw him speak years ago and wrote him off as nuts, but I do try to keep tabs on developments.
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I wonder if I will start noticing him more now that you've pointed him out. If you want your day ruined, you can search on TikTok to find the MANY providers making witchiness a part of their professional practice. Anything that moves me closer to be perceived as a "guide" or "guru" makes me run.
 
Shiori said:
Eclectic witchcraft has been popular for a while. There are several books on blending mental health/psychotherapy and witchcraft. I think one of the most popular ones is The Witch Wound. Then there was the super popular Shadow Work Journal that made the rounds in witchy circles before expanding to a more mainstream audience. Even in the VA, I had clients referencing it. I haven't seen the gentleman in the video, but he has a lot of competition in that space.
Yes, I'm chronically online.
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I’m going to pretend to be blissfully ignorant about this. Just for today.
 
cara susanna said:
Someone in the therapist sub posted about how licensure should require the therapist to have been in therapy themselves, and I'm pleasantly surprised by how much pushback that's getting.
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If these people want tripartite training so bad then go to a psychoanalytic institute geez 😔
 
Shiori said:
Eclectic witchcraft has been popular for a while. There are several books on blending mental health/psychotherapy and witchcraft. I think one of the most popular ones is The Witch Wound. Then there was the super popular Shadow Work Journal that made the rounds in witchy circles before expanding to a more mainstream audience. Even in the VA, I had clients referencing it. I haven't seen the gentleman in the video, but he has a lot of competition in that space.

Yes, I'm chronically online.
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I'm all for the use of metaphor in psychotherapy but something tells me these people are serious about the whole 'dual classing' as psychologist/witches (or warlocks) thing. Sheesh.

"Eclectic witchcraft"...I'm gonna have to steal that one, lol.
 
Someone posted about EMDR not being front line in the new APA PTSD CPG in the therapist sub and some of the responses are about what you might expect (although I admit I've been pleasantly surprised overall)

People keep talking about CBT and exposure like they're separate approaches, which is driving me bananas
 
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cara susanna said:
Someone posted about EMDR not being front line in the new APA PTSD CPG in the therapist sub and some of the responses are about what you might expect (although I admit I've been pleasantly surprised overall)

People keep talking about CBT and exposure like they're separate approaches, which is driving me bananas
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Well, the modal person on the therapists sub truly believes that the entirety of the CBT framework is just telling patients that their thoughts are wrong/irrational. You can't expect these people to understand the nuances of modalities and techniques within the CBT framework.
 
WisNeuro said:
Well, the modal person on the therapists sub truly believes that the entirety of the CBT framework is just telling patients that their thoughts are wrong/irrational. You can't expect these people to understand the nuances of modalities and techniques within the CBT framework.
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Considering that many midlevel practitioners (which I assume makes up the bulk of the therapist sub) get only exposure to CBT in their training, this is the outcome I would expect. Still, it would be nice if they at least try to embody the spirit of Socratic questioning rather than pretending they know WTF they're talking about.
 
R. Matey said:
Considering that many midlevel practitioners (which I assume makes up the bulk of the therapist sub) get only exposure to CBT in their training, this is the outcome I would expect. Still, it would be nice if they at least try to embody the spirit of Socratic questioning rather than pretending they know WTF they're talking about.
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I was trained by a pretty prominent cognitive therapist and the two major things he emphasized were:

1) The importance of the therapeutic relationship (and its collaborative nature)
2) Socratic questioning
 
cara susanna said:
Someone posted about EMDR not being front line in the new APA PTSD CPG in the therapist sub and some of the responses are about what you might expect (although I admit I've been pleasantly surprised overall)

People keep talking about CBT and exposure like they're separate approaches, which is driving me bananas
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I am also pleasantly surprised by some of the comments, but there's also a lot of "well my lived experience is that IFS works best for my clients" or "I wonder if this is just a ploy to get EMDR not covered by insurance." This latter claim is super weird because insurance almost never asks for anyone to even report their modality.
 
EnPsychlopedia said:
I am also pleasantly surprised by some of the comments, but there's also a lot of "well my lived experience is that IFS works best for my clients" or "I wonder if this is just a ploy to get EMDR not covered by insurance." This latter claim is super weird because insurance almost never asks for anyone to even report their modality.
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Everyone knows that CBT is only the "gold standard" because insurance companies want shorter treatments so they pay less. It's also well known that not only does Wayfair traffic children for sex slavery, but they are also part of the CBT research funding cabal!

/s
 
We also had a psychiatric resident in our training cohort for cognitive therapy who asked the mentor if he could provide 'a list of Socratic questions' to use.

It was a key moment in my development illustrating the fundamental differences between medical/psychiatric and clinical psych training.

I also suppressed the urge to ask the resident, "Why would you need a list of Socratic questions?" with a straight face.
 
WisNeuro said:
Everyone knows that CBT is only the "gold standard" because insurance companies want shorter treatments so they pay less. It's also well known that not only does Wayfair traffic children for sex slavery, but they are also part of the CBT research funding cabal!

/s
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And "they're easier to study because they're manualized" or "the studies exclude complex patients"
 
WisNeuro said:
Everyone knows that CBT is only the "gold standard" because insurance companies want shorter treatments so they pay less. It's also well known that not only does Wayfair traffic children for sex slavery, but they are also part of the CBT research funding cabal!

/s
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something something late stage capitalism something something microdosing.
 
Fan_of_Meehl said:
We also had a psychiatric resident in our training cohort for cognitive therapy who asked the mentor if he could provide 'a list of Socratic questions' to use.

It was a key moment in my development illustrating the fundamental differences between medical/psychiatric and clinical psych training.

I also suppressed the urge to ask the resident, "Why would you need a list of Socratic questions?" with a straight face.
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As an intern, I sat is a multidisciplinary CE/case conference about a patient with a terminal disease that was asking for assisted suicide. In a room full of nurses, physicians, and other health professionals (maybe 30-50 people) it was only the two psychology interns that thought to ask why the patient wanted to die. Turned out to be the only important question in the whole case.
 
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Okay, I need to complain about this somewhere where people will understand. I'm watching a Korean drama that deals with alcoholism. The male lead, a doctor, just said in a seminar that the best way to deal with alcohol withdrawal symptoms is to ride them out until they improve. WHAT? That strikes me as so irresponsible, especially in a country with as high of alcohol use and mh stigma as South Korea.
 
cara susanna said:
Okay, I need to complain about this somewhere where people will understand. I'm watching a Korean drama that deals with alcoholism. The male lead, a doctor, just said in a seminar that the best way to deal with alcohol withdrawal symptoms is to ride them out until they improve. WHAT? That strikes me as so irresponsible, especially in a country with as high of alcohol use and mh stigma as South Korea.
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Well, if they survive the DTs and potential acute encephalopathic episode, maybe it will become a strong enough aversive stimulus to override the addictive impulses 😉
 
cara susanna said:
Okay, I need to complain about this somewhere where people will understand. I'm watching a Korean drama that deals with alcoholism. The male lead, a doctor, just said in a seminar that the best way to deal with alcohol withdrawal symptoms is to ride them out until they improve. WHAT? That strikes me as so irresponsible, especially in a country with as high of alcohol use and mh stigma as South Korea.
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Whatever you do, don't give them tons of black coffee like they do in vintage Westerns to 'sober them up,' lol.

I mean, unless you're tossing in a couple of 'lumps' of Librium into the brew.

Seriously, though, I would imagine that it would depend upon the particular recent imbibing history of the individual (if you can discern that accurately based on self-report) and monitoring of their vitals and MSE.

If someone has been drinking the equivalent of a fifth of 80-proof liquor per day, every day, for several years...yeah, you're gonna need some pharmacological help to ease the withdrawal/discontinuation syndrome to avoid catastrophically high BP readings, strokes, insane tachycardia, seizures, and maybe even actual delirium tremens (especially in seriously physically ill individuals).

If, however, someone who was 'in recovery' for years had a 'slip-slide' relapse that started about three weeks ago involving maybe binging a six-pack or two on the weekends...which then became approximately an 'every-other-day' habit for the past week or so...they could probably ride it out without benzos.
 
Fan_of_Meehl said:
Whatever you do, don't give them tons of black coffee like they do in vintage Westerns to 'sober them up,' lol.

I mean, unless you're tossing in a couple of 'lumps' of Librium into the brew.
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I skip the morning librium brew and go straight for a few cubes of Antabuse for flavoring. Problem will work itself out that way.

Rachel Brosnahan Success GIF by Saturday Night Live
 
Fan_of_Meehl said:
Whatever you do, don't give them tons of black coffee like they do in vintage Westerns to 'sober them up,' lol.

I mean, unless you're tossing in a couple of 'lumps' of Librium into the brew.

Seriously, though, I would imagine that it would depend upon the particular recent imbibing history of the individual (if you can discern that accurately based on self-report) and monitoring of their vitals and MSE.

If someone has been drinking the equivalent of a fifth of 80-proof liquor per day, every day, for several years...yeah, you're gonna need some pharmacological help to ease the withdrawal/discontinuation syndrome to avoid catastrophically high BP readings, strokes, insane tachycardia, seizures, and maybe even actual delirium tremens (especially in seriously physically ill individuals).

If, however, someone who was 'in recovery' for years had a 'slip-slide' relapse that started about three weeks ago involving maybe binging a six-pack or two on the weekends...which then became approximately an 'every-other-day' habit for the past week or so...they could probably ride it out without benzos.
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Yeah, I wouldn't mind if this were tailored clinical advice for an individual patient, but this was in a seminar he was giving to the public
 
WisNeuro said:
Well, the modal person on the therapists sub truly believes that the entirety of the CBT framework is just telling patients that their thoughts are wrong/irrational. You can't expect these people to understand the nuances of modalities and techniques within the CBT framework.
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I think you’re giving the modal too much credit to know anything about CBT at all. It’s like the self-identified “client-centered” counselors that I work with who come out of a masters program with no knowledge of Rogers and use of reflections. Foundational and theoretical basics just seem to be absent. One student I’m supervising was told by one of his instructors that kids should never be told no so I guess that’s what they are learning instead of how to do therapy.
 
smalltownpsych said:
I think you’re giving the modal too much credit to know anything about CBT at all. It’s like the self-identified “client-centered” counselors that I work with who come out of a masters program with no knowledge of Rogers and use of reflections. Foundational and theoretical basics just seem to be absent. One student I’m supervising was told by one of his instructors that kids should never be told no so I guess that’s what they are learning instead of how to do therapy.
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Well, yeah. Repeatedly hearing "no" as a kid results in lifelong trauma that can only be treated with a combination of IFS and polyvagal therapy.

/s
 
I just wanted to quickly say a huge thank you to all of you. I am currently in the process of attempting to appeal to our department of psychiatry to allow for prescribing psychologists to practice, consistent with state legislation, and I literally got the impression from some of the psychiatrists regarding how psychologists do not understand pharmacology and complex body systems. I feel like the discussion here is a refreshing reminder that we are consistently thinking about these things...
 
RxPsych said:
Well, yeah. Repeatedly hearing "no" as a kid results in lifelong trauma that can only be treated with a combination of IFS and polyvagal therapy.

/s
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R. Matey said:
with MDMA, of course.
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Isn't that just a rave? Actually, the rave likely incorporates some EMDR by virtue of the music and lights.
 
cara susanna said:
Someone posted about EMDR not being front line in the new APA PTSD CPG in the therapist sub and some of the responses are about what you might expect (although I admit I've been pleasantly surprised overall)

People keep talking about CBT and exposure like they're separate approaches, which is driving me bananas
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Yea, people think all Behavioral & Cognitive Therapies can be summed up as Beck’s CbT. Very frustrating. Folks just don’t get how there is a ton of good learning, behavioral, social, and cognitive science wrapped up in this family of treatments and they’re not all the same.
 
The r/psychiatry subreddit is almost as much of a psychoanalytic circlejerk as r/psychoanalysis, and almost as pseudointellectual. Literally every time someone posts something about getting a recommendation for how to enhance their practice or case conceptualize, it is almost invariably "Go to formal psychoanalytic training at an institute and read everything ever written by Nancy McWilliams and Jonathan Shedler." I already shudder when I see those two names get recommended, but I dare say that I shudder harder when I see it coming from physicians.
 
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EnPsychlopedia said:
The r/psychiatry subreddit is almost as much of a psychoanalytic circlejerk as r/psychoanalysis, and almost as pseudointellectual. Literally every time someone posts something about getting a recommendation for how to enhance their practice or case conceptualize, it is almost invariably "Go to formal psychoanalytic training at an institute and read everything ever written by Nancy McWilliams and Jonathan Shedler." I already shudder when I see those two names get recommended, but I dare say that I shudder harder when I see it coming from physicians.
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Maybe, but remember that the research training here, in general, is pretty surface level.
 
oliversacks4thewin said:
I just wanted to quickly say a huge thank you to all of you. I am currently in the process of attempting to appeal to our department of psychiatry to allow for prescribing psychologists to practice, consistent with state legislation, and I literally got the impression from some of the psychiatrists regarding how psychologists do not understand pharmacology and complex body systems. I feel like the discussion here is a refreshing reminder that we are consistently thinking about these things...
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I often run into and work with psychiatric nurse practitioners (they're quite common on skilled nursing/rehab/nursing homes) and the amount of times they either just completely write off psychologists, practice beyond their scope, or seemingly misidentify themselves to patients is stunning.

Had one that told me they do "therapy" with patients despite having zero background, training, or experience because they said "they teach courses at a local college and have been doing this for a long time so know what to do" then asked me why I was billing the same codes as them and told me I shouldn't see most patients unless she determined it was appropriate lol.

Now have another at another location, who apparently sees patients before I do and now I have to take time with each patient ti provide psychoeducation about the difference between psychologists, psychiatrists, and psychiatric nurse practitioners. Not as bad as the first one, but still. Almost every one who meets this one then tells me they don't need to be evaluated because "the psychiatrist was here already."

Most of them are well intentioned, but then those end of referring patients to me because "they're sad" or they "are angry" and then I see the patient and it's just frustration and anger at how poorly run some of these rehabs are.

Anyways psychologist prescribing rights are on the table where I'm licensed, a lot of psychiatric nurse practitioners about to be out of work. The first one i mentioned retired shortly after this news broke. Well i also reported the first one for practicing outside their scope as well.

But soapboxing aside, I agree, this is something many of us are thinking about.
 
quickpsych said:
I often run into and work with psychiatric nurse practitioners (they're quite common on skilled nursing/rehab/nursing homes) and the amount of times they either just completely write off psychologists, practice beyond their scope, or seemingly misidentify themselves to patients is stunning.

Had one that told me they do "therapy" with patients despite having zero background, training, or experience because they said "they teach courses at a local college and have been doing this for a long time so know what to do" then asked me why I was billing the same codes as them and told me I shouldn't see most patients unless she determined it was appropriate lol.

Now have another at another location, who apparently sees patients before I do and now I have to take time with each patient ti provide psychoeducation about the difference between psychologists, psychiatrists, and psychiatric nurse practitioners. Not as bad as the first one, but still. Almost every one who meets this one then tells me they don't need to be evaluated because "the psychiatrist was here already."

Most of them are well intentioned, but then those end of referring patients to me because "they're sad" or they "are angry" and then I see the patient and it's just frustration and anger at how poorly run some of these rehabs are.

Anyways psychologist prescribing rights are on the table where I'm licensed, a lot of psychiatric nurse practitioners about to be out of work. The first one i mentioned retired shortly after this news broke. Well i also reported the first one for practicing outside their scope as well.

But soapboxing aside, I agree, this is something many of us are thinking about.
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At our VA, the independently prescribing APRN's who essentially function as psychiatrists in this setting routinely farm out the responsibility of differential diagnosis to psychologists, particularly (a) ADHD (I mean, of course), (b) PTSD (this is becoming increasingly common), and (most recently), (c) bipolar disorder (which kind of blows my mind). Having recently been assigned a consult to rule in/out bipolar disorder in a patient who was already established with the APRN, my initial thought was, "umm...YOU'RE their prescribing provider...do YOU think they have bipolar disorder?"
 
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