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R. Holmes - the Pawn
@SystemicPawn
PBC & PAN Theory – Pressure System Psychology. Where Patterns, Pressure, Development, Environment and Autonomy Meet.
Utrecht, Nederland
Joined June 2026
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PBC & PAN Theory
PAWN → Map the system
BOOMERANG (Conflict, Projection) Feedback Cycle → Spot repeating patterns
COMPASS → Build autonomy and choice
IMAGINARY ARMY → Understand invisible pressure
PRESSURE SYSTEM → Fight, Flight, Freeze
PEEKABOO RHYTHM → Recurring relationship cycles
DEVELOPMENTAL ANALYSIS → Understand the past
SYSTEMIC MAPPING → Understand the environment
No labels. Only mechanisms.
PBC & PAN was designed as a developmental and systemic framework that can be used before diagnosis, before labels, and ideally before problems become deeply ingrained. It can help identify patterns that may resemble certain diagnostic categories without reducing a person to a label. The purpose is not to replace existing diagnoses, but to provide additional context through developmental analysis and systemic mapping. This can be especially valuable for children and adolescents, where early labels may sometimes become part of identity formation. The focus is understanding development, relationships, environment, and pressure dynamics before conclusions are drawn.
That’s an interesting question.
"And so that's where the question goes. What is the causal explanation for the distinctions you're pointing to, not whether the distinctions are real?"
Applies very much to psychiatry too.
If bullying and neurodivergence are “not separate issues,” how did the study establish which came first?
How did it distinguish neurodevelopmental traits from adaptations to chronic bullying?
And if that distinction was never established, what exactly are we concluding?
@5By5Creativity @newscientist If bullying and neurodivergence are “not separate issues,” how did the study establish which came first?
How did it distinguish neurodevelopmental traits from adaptations to chronic bullying?
And if that distinction was never established, what exactly are we concluding?
Freud. Karl Friston. Connect the dots.
@BBCNews Uta Frith has a point. But what if bullying, maltreatment, social pressure, school or an unsafe environment remain invisible, sometimes even unspoken by the child or adolescent? If we find an autism or ADHD label first, how do we know we haven’t stopped investigating too soon?
Cold exposure may be useful. But what happens when a useful habit becomes another performance target? If every week has to be colder, longer, harder and “better,” are we still regulating ourselves, or have we simply turned self-care into another achievement system?
Cold shock. Instant focus.
30 seconds of cold water triggers a 250% dopamine spike. Unlike coffee, there's no crash. The alertness lasts for hours.
Free biological caffeine. Every morning. In your shower.
Source: European Journal of Applied Physiology
Autonomy is not the absence of influence. It is becoming aware of what influences you, so that influence does not automatically become your choice.
#PBCPAN #Psychology #PSP
An 11-year-old is not a finished adult: the prefrontal cortex is still developing. Many young people who struggle to focus at school later thrive when they find purpose, motivation and an environment that fits them. Are we only measuring attention, or also asking what makes attention possible?
That poor kid hated the drugs, loved being off them, finally felt himself without them, making huge progress with friends & family, and was only put back on them as the school did not make sufficient accommodations due to poor resources (come to one of our state primaries, Tyler)
Indeed. It is essential to distinguish observation, interpretation, and hypothesis. What we observe is not automatically an explanation for why the behaviour occurs. A hypothesis should therefore remain open to developmental, relational, cognitive, environmental, and biological context. The goal is not to fit the person into the hypothesis, but to keep testing whether the hypothesis fits the person.
Why can’t we instead be honest about what ADHD is—and what it is not—as psychiatrist @awaisaftab is here, in an @nytimes article from earlier this year?
Why the insistence on presenting it as an established neurological issue and confusing people?
https://t.co/07bMinDFj0
This is the problem with 300+ DSM labels. Root causes and environmental factors, including bullying and child maltreatment, can be missed when the label becomes the explanation.
A boy was diagnosed with ADHD. Poor concentration, school avoidance, medication, the explanation seemed complete.
What remained unseen was years of bullying. He skipped school not because he “couldn’t focus,” but because he was afraid. At his lowest, he stood at a railway station contemplating suicide.
Later he said: “I wish someone had asked further. I was too afraid to tell them.”
Psychiatrist Jim van Os has repeatedly questioned a system built around 300+ diagnostic labels, arguing that these categories are not biologically demonstrable as discrete diseases and that we need to pay far greater attention to a person’s context, experiences and environment.
Could confirmation bias be part of the problem?
Once a diagnosis has been established, do clinicians become more likely to interpret subsequent behaviour through that diagnostic lens, poor concentration becomes ADHD, school avoidance becomes ADHD, while alternative explanations receive less attention?
If the label explains the behaviour, who still investigates the environment?
And how do we build a system where a diagnosis never becomes the end of the investigation?
But before distinguishing “disorder” from “normal distress,” shouldn’t we first investigate the environment? If severe family adversity or bullying can produce significant impairment, when does a DSM label clarify the problem, and when does it obscure its source?
DSM requires presence of "Clinically Significant Distress Or Impairment" before making any psych diagnosis.
Goal: Distinguish mental disorders from normal distress.
Problem: Unclear definition> fuzzy boundary with normal.
Soln: Watchful waiting beats careless overdiagnosis.
We’ve been sold a lie that mental illness is a broken brain disease, disorder, or illness or whatever made up label you prefer, caused by genetics or "imbalances".
Evidence from these books will show:
Chronic fight-or-flight activation + systemic inflammation generate the symptoms.
The gut microbiome modulates mood and cognition.
Neuroprogression can advance—or reverse.
Psychotropic drugs frequently disrupt metabolism and brain mitochondria.
Yet the same autonomic stress-response system that causes the symptoms, can be regulated & recovered through a dynamic neuroimmunoendocrine process that we can influence, change, and heal.
Time to retire the outdated model.
The same can be true for children experiencing maltreatment or bullying when their distress is misinterpreted through the ''wrong'' DSM label. An incorrect diagnosis can be dangerous too. A boy was diagnosed with ADHD. Poor concentration, school avoidance, medication, the explanation seemed complete. What remained unseen was years of bullying. He skipped school not because he “couldn’t focus,” but because he was afraid. At his lowest, he stood at a railway station contemplating suicide. Later he said: “I wish someone had asked further. I was too afraid to tell them.” If the label explains the behaviour, who still investigates the environment? And how do we build a system where a diagnosis never becomes the end of the investigation?
Royal College of Psychiatrists not taking a prime opportunity to correct misunderstanding. As I say in my article:
"The psychiatric profession is clearly implicated here—if not always by actively promoting reification, at least by remaining largely silent on its proliferation."
https://t.co/gzUFG12sYg
I reposted this on LinkedIn for a little more reach.
Of the 80 authors of the 2021 World Federation of ADHD International Consensus Statement, at least 41 (51%) disclosed having financial ties with drug companies. Independent reviews also identify additional historical drug company relationships that weren't disclosed in the...
Indeed.
Poor concentration, social/school/work avoidance, “executive functioning dysfunctions”, impulsivity, attentional and task initiation problems, etc. can all be due to unresolved, neglected or untreated emotional issues. Most ADHD and autism diagnoses are fallacious. BPD was similarly thrown at everyone who seemed difficult back in my day. Curiously, BPD was (and still is) the diagnosis of choice for challenging female patients and gay/bisexual men. On the other hand, today, autism and ADHD seem to explain away unresolved conflicts among men in general.
Channel 4’s new documentary The Great ADHD Myth? heard medical experts question whether ADHD is a genuine neurodevelopmental disorder, or a social construct.
Dr Iona Heath, the former president of the Royal College of General Practitioners, was among them, who said in an interview with The Telegraph that she “would ban the label ADHD”.
Now, we hear from the Chief Medical Officer at the Centre for ADHD Research and Excellence about his perspective having watched the documentary 👇
https://t.co/zDeRkFAd2y
A boy was diagnosed with ADHD. Poor concentration, school avoidance, medication, the explanation seemed complete.
What remained unseen was years of bullying. He skipped school not because he “couldn’t focus,” but because he was afraid. At his lowest, he stood at a railway station contemplating suicide.
Later he said: “I wish someone had asked further. I was too afraid to tell them.”
Psychiatrist Jim van Os has repeatedly questioned a system built around 300+ diagnostic labels, arguing that these categories are not biologically demonstrable as discrete diseases and that we need to pay far greater attention to a person’s context, experiences and environment.
Could confirmation bias be part of the problem?
Once a diagnosis has been established, do clinicians become more likely to interpret subsequent behaviour through that diagnostic lens, poor concentration becomes ADHD, school avoidance becomes ADHD, while alternative explanations receive less attention?
If the label explains the behaviour, who still investigates the environment?
And how do we build a system where a diagnosis never becomes the end of the investigation?
@wimvegt Newton’s Third Law: what you push outward pushes back.
I actually think #TheGreatADHDMyth was inspirational. How have we allowed Big Pharma, careless GP's, snake oil salesmen with their absurd tests/pacifying drugs to impact tens of thousands of children and adults with a 'neuro developmental' diagnosis/condition/label? I am not an ADHD denier, but 100% believe it's a social construct - and that is where treatment needs to begin
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