Interviewing @JonathanShedler soon on depressive personality…

Notes:

Family history of depression (many genes)…

As a child being consistently:
criticized
shamed
emotionally ignored
chronic household dysfunction
*dose-response relationship

Parents high criticism/authoritarian and low warmth/neglect Epigenetic issues with stress-response system

Simultaneously often development of…
Insecure Attachment with beliefs like “I am not worthy of love or support”

1/ If a patient is willing, I will often start with therapy, exercise, diet, and sleep optimization (exceptions below).

I look for the biggest win

1. Eliminate addictions (THC, Alcohol)
2. Exercise (I like to alternate cardio/strength) 2/ Cont...

3. Diet: Mediterranean for most of the time, emerging evidence for Keto for schizophrenia/bipolar,
4. Sleep: consistency, goal is small changes, screen for OSA
5. Therapy (~biggest win): I tend to pick the practitioner above modality (high Reflective function)

1/ If you are here on X because of the TikTok ban, this may be good for your 🧠…

Hear me out…

Several years ago, I was in that world (my account is still >100k) but decided to stop watching and here is why… 2/ A study (Chen, 2022) showed addicted users (I was one of them) did worse on the “stroop task”…

The Stroop Test is a psychological tool that evaluates cognitive flexibility and the ability to maintain focused attention.

1/
A 2012 study by Patricia Resick et al. explored Cognitive Processing Therapy (CPT) with and without expressive writing for PTSD. Writing about trauma alongside CPT increased PTSD symptom change in those with high levels of dissociation. 2/
The study used the 30-item Multiscale Dissociation Inventory (MDI) to assess 6 dissociation types: disengagement, depersonalization, derealization, emotional constriction, memory disturbance, and identity dissociation. Higher scores indicate greater dissociation.

Woke up at 4 am to my son having a bad dream. I regulate his body with my calmness. He said "daddy don't tell me what it means till the morning"... I precede to get up and read the following studies as I prepare for recording an episode on reflective function: 1) Fonagy et al, 1996 showed that reflective function mediates the relationship between abuse and development of BPD

d1wqtxts1xzle7.cloudfront.net/45399757/The_R…

Nancy McWilliams: Mental health in relationships is depicted through showing love and devotion to another person by accepting them as they are. This includes several other capacities, such as:
•Being fully emotionally honest.
•Being able to acknowledge … twitter.com/i/web/status/1… "Listening in a professional capacity is a disciplined, meditative, and emotionally receptive activity in which the therapist's needs for self-expression and self acknowledgment are subordinated to the psychological needs of the client" (McWilliams, 2004, psychiatrypodcast.com/psychiatry-psy…… twitter.com/i/web/status/1…

1/8 Obsessive-compulsive personality is externally defined by high conscientiousness, meticulousness, and being highly regimented and cerebral with low emotional awareness.

@jonathanshedler #psychtwitter #OCPD #psych #psychodynamic 2/8 When asked how they feel about something, someone with OCP will instead tell you what they think. The overuse and overvaluation of thinking, reasoning and logic is a defense against emotional life.