Just saw Nolan's the Odyssey. Incredible film. It really is an epic. There's one thing that I don't like about it that I think is a reflection of our world and particularly family life.

***Spoilers*** At the end, Odysseus sets Telemachus up on the throne and then falls off with Penelope to the utter West to offer sacrifice for his dear comrades

It's a complicated issue.
It's easier to validly and reliably dx aut in children under ~6y/o.
Totally anecdotal but trained in a developmental clinic where we Frankensteined an assessment that was incredibly useful.

https://twitter.com/DoctorPerin/status/1913609735472849381

You don't need strict scoring to spot aut in children. You do need to watch kids b/c some will grow out of aut symptoms proving that the dx was something related like PDD NOS, severe speech issues, severe gut or brain syndromes, etc.

I did a mental review of how effective I seem to be w/ patients and what has contributed to successfully helping them and what's gotten in the way. None of it was surprising but still helpful to think about and so here's a thread To start, I count successful tx as accomplishing one or more of these:
1. Stabilizing the Pt
2. Maintaining stability when it's threatened
3. Helping them make meaningful and lasting improvements to their internal worlds and quality of life

Neurodiversity is a good addition to psych but taking it uncritically into dx systems means ignoring a host of useful and meaningful diagnoses, especially borderline states that are not outwardly chaotic. Ignoring these CAN mean dxing a pt w/ a condition that's endogenous and needs accommodation and very gradual assimilation of society to the person and vice versa when they may actually have a condition that's far more readily changeable and if changed, would lead to a more satisfying life.

I think St. Thomas Aquinas is right that in some way, when we turn a sensation/experience into thought or memory, we are making an imperfect copy of reality. Taking that point, when we introject, we are making an imperfect copy of the introjected person.

https://twitter.com/PoetryofAfter/status/1631716057647022080

We don't just copy the words but what we feel or sense to be their meaning which can include the emotions, motivations, wants, desires, demands, facial expressions, power, and importance of the words and the person/object that we introject.

@DrGipps Not exactly because a symbol remains ambiguous. It's more like going to a sign that hillsy definite meaning. You're encountering another Christ in the sense that they signify Christ by being imbued with the meaning He holds and conveys @DrGipps Put less like linguistically, being intimately conformed and joined to Christ, the saints offer: a different way to see/know/interact with Christ, fraternity within the Christian relationship, and a link to Christ we canore easily grasp

Autism in children can be mistaken for psychosis. Some autistic kids talk to themselves or externalize the interactions/imaginations they're having internally in ways that aren't immediately recognizable as fantasy or play. They might say they hear voices. Clinically, it's necessary to inquire more. The voices could be hallucinations but might just be a child's way of describing intrusive or unwanted thoughts, their own internal voice, or restating concerns they've heard from mom and dad

Autism and ADHD assessments would really benefit from an influx of psychodynamic/analytic personality theory and process theory. A problem I see frequently is missing a diagnosis b/c the assessor only paid attention to behavior but missed internal experience. Behavior is a part of what the assessment seeks after but if you don't know the inner experience too, you can't make an informed diagnosis. A few examples:

Reading HS Sullivan’s The Interpersonal Theory of Psychiatry. It’s the first book of his I’ve read but I’ve been fascinated by attachment and relational approaches since my first year in psych training. He has a really interesting basis and distinction around fear vs anxiety. 🧵 “…the tension of needs, which can be satisfied, and which can be experienced as fear of a danger of the need; and the tension of anxiety, which is brought about by the interpersonal situation….