Persona

[Persona @imalotlikeyou_]

@tylerblack32 @RobynUrback This is the only decision that precludes any action being taken by amor towards the subject. It is of a fundamentally different order, and though this is X, your glibness does not come across well.

[Persona @imalotlikeyou_]

@proud_penelope When they go Har-low, we go Har-High! 🙃

[Naomi Fisher @naomicfisher]

Sometime before 2016, a psychiatrist started asking their late-diagnosed adult patients with ADHD whether they thought they were more sensitive to rejection and failure than other people.

They said that they were. He didn’t (as far as I can tell) do any comparison with people with mental health problems, or with those with social anxiety. He didn’t look at children or those diagnosed in childhood. He just asked his patients to self-compare with others.

There were no attempts to test out whether this was specific to ADHD, nor universal in those with ADHD.

In 2016, the psychiatrist, William Dodson, gave this a name - rejection sensitivity dysphoria - and started writing about it. It resonated with influencers who created content talking about their RSD. It quickly multiplied. Articles were written about it on official sounding websites. Qualitative research was done, asking people who had heard about RSD whether they experienced it and what it was like.

By 2024, Dodson was saying that RSD was neurological and genetic, not related to trauma and wouldn’t respond to psychotherapy.

By 2026, bestselling author Alex Partridge wrote a whole book about his RSD, pinning it squarely to ADHD and saying that RSD ‘explained my entire life’. He gave a convincing sounding brain-based explanation about ‘glitches’ in how the ADHD brain processes dopamine and nor-epinephrine, and how these lead to rejection feeling far more brutal than for people without ADHD. There is no evidence of this that I have found.

And in this way a psychological and emotional reaction was framed as a neurobiological symptom. Millions started to think that perhaps they had ADHD, because they were sensitive to rejection and failure. RSD spread, and soon people started saying it was part of autism too.

Why does that matter? Because when people think something is due to how their brains work, they think that it is set in stone and won’t change. They think that medication is their only option, and that psychotherapy has nothing to offer. Emotional sensitivity is a really common psychological symptom, and it hasn’t been shown that it’s uniquely part of ADHD. RSD is an example of how neurodivergence is expanding to incorporate emotional reactions, and in the process turning psychology into neurology.

With RSD, the most basic scientific questions haven’t been answered, but you’d never know that from what you see online. There, it all seems so certain and clear.
It’s not.

[Persona @imalotlikeyou_]

@truth_bond71372 @vividvoid Ding ding ding

[Persona @imalotlikeyou_]

@EBasilion Ask yourself where or from whom people get their values, and how they - the values and the values giver - are encoded/related to. That relational dimension perhaps a more determinative variable vis a vis the link between values and mental illness.

[Persona @imalotlikeyou_]

@Yuzuna_Rinako @JDHaltigan To be somewhat sympathetic to both of you here. Dionysus is male, but he represents a masculine figure that immerses himself wholly in feminine delight, chaos, dance, pleasure and intoxication of eros. Why his followers the “maenads” were women.

[Carl Hindy, Ph.D. @DrCarlHindy]

My personal truth as a clinical psychologist, for today (October 3, 2026): People often grieve the childhood they never had.

Grief isn’t only about losing something we once possessed. We can also grieve what should have been there but wasn’t.

A parent who felt safe. Affection that came freely. Someone who noticed. A home where mistakes didn’t threaten belonging. The freedom to be a child rather than the one who kept everything together.

These losses can remain surprisingly alive in adulthood. We may find ourselves still seeking the reassurance, approval, protection, or unconditional acceptance we missed decades ago.

Part of growing up is recognizing that history cannot be rewritten. But it can be understood. We can gradually stop asking the present to repair everything the past failed to provide.

[Persona @imalotlikeyou_]

@KemtrupTweets Realize yr referring to Ogden, not DW, but just my thoughts after reading yr post after a day of work that did really did have that “magic” feel present. And yes, we will inevitably return to the body. And selection bias is def at work with vignettes! Appreciate yr writing here🙏

[Persona @imalotlikeyou_]

@KemtrupTweets Always helpful to be reminded of that, I think. I’m not sure I know exactly what you’re referring to in their work. But as an example, Winnicott isn’t saying be nice to the inner child, he literally says “survive it”. Which is a far more intense process than being nice.

[Edward A. Perin - Psychologist @DoctorPerin]

“No one who, like me, conjures up the most evil of those half-tamed demons that inhabit the human beast, and seeks to wrestle with them, can expect to come through the struggle unscathed.”
--Sigmund Freud

[Carl Jung Archive @QuoteJung]

I keep rereading this paragraph from Carl Jung about avoidance:

[Jayce Long @JayceLong]

A sign of movement in psychotherapy is when grievances transform into grieving.

[Persona @imalotlikeyou_]

@jefffinethomas Also possible with this kind of patient is splitting - experiencing the therapist’s “finding freedom” in a situation as a dangerous intrusion- their boundarylessness defended against with a reaction formation of hypervigilant constriction.

[Jonathan Shedler @JonathanShedler]

“If she were capable of receiving love and support, she wouldn’t be coming to you for them. That’s a real problem. And until it’s treated, she won’t be able to take anyone’s advice and that’s why she needs therapy”

[Persona @imalotlikeyou_]

@AlobhaPatrick “Just like you should in every healthy relationship”≠“common sense” though. Do you think most people are aware or even able to become aware of their or the other’s projections in their intimate relationships and working through why they have them? Doesn’t seem very common to me.

[Jonathan Shedler @JonathanShedler]

Training in psychotherapy begins in earnest when it finally sinks in that giving advice does not help.

And it sinks in that common-sense solutions didn’t help in the past and won’t help now.

Meaningful psychotherapy is not an extension of common sense. It is something else entirely.

Why don't advice and common sense help?

ONE crucial reason is that the problem you see on the surface is rarely the problem that therapy needs to address.

There is the surface or “manifest” problem—and there are the underlying psychological problems that give rise to it, and have gotten in the way of previous efforts to address it.

In other words, there is WAY more going on than meets the eye. What you see is almost never what you get.

Advice and commonsense solutions focus on “first-order” causes. Meaningful psychotherapy addresses 2nd-, 3rd-, and nth-order causes.

This is why meaningful psychotherapy requires real expertise and years of training. *We are not addressing the same problems*.

This is why psychotherapy is so often misunderstood.

This is why therapists who are still trying to give advice or provide common-sense solutions are not expert therapists. Their psychotherapy training never began in earnest.

No matter what degrees they have or how how many years of experience, they are operating with a beginner-level understanding of human psychology and providing beginner-level psychotherapy.

“Training in psychotherapy begins in earnest when it finally sinks in that giving advice doesn’t help.”
_____

✍️ Related essay: Much of What Is Called Therapy Is Not Psychotherapy
https://t.co/qtJCpP91Dj

[Mahlerite @jesusrglez]

Going against Freud’s conception of primary narcissism (a state of self sufficiency), Klein comments “there’s no instinctual urge, no anxiety situation, no mental process which does not involve objects, external or internal, object relations are at the center of emotional life”

[Kemtrup @KemtrupTweets]

Here is my best attempt to simplify and clarify a Winnicottian perspective on psychopathology, development and therapy. It is highly compatible with neuropsychoanalysis I think, but also ideas from all corners of psychoanalysis (perhaps even French!)

[Awais Aftab @awaisaftab]

I’m still chewing over the sentence, “I am a person who tells survivors of abuse their personalities are disordered.” There is so much implicitly happening here. It seems to assume that personality disorders are inherently stigmatizing, that they convey a disparaging moral assessment (“you are a bad/wicked person”), and that a personality disorder somehow detracts from a person’s experience of abuse/trauma. Clearly these are all misunderstandings. Anyone charitably reading the literature (say Nancy McWilliams on personality disorders) can tell these are misunderstandings.

Anything can be misunderstood in this way. You could say the same about “telling survivors of abuse they have a mental illness” if you understood mental illness to be inherently degrading and at odds with sequelae of trauma. One could even turn “developmental trauma” into a derogatory diagnosis if one said that with condescension, disgust, and eye-rolling.

I don’t think clinicians should be ashamed of giving a personality disorder dx if that is indeed their genuine assessment and if care is offered in a collaborative manner with respect for a person’s agency and dignity; I do think clinicians should be ashamed of treating patients in a dehumanizing manner, regardless of the diagnosis.