Weekly online podcast interviews with comedians, artists, friends, and the occasional doctor. All exploring mental illness, trauma, addiction and negative thinking.

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Females on the Autism Spectrum: A Guest Blog by Dr. Joel Schwartz

In general, Asperger’s Disorder is a form of autism. In the current edition of the Diagnostic and Statistical Manual of Psychiatric Disorders, Aspergers has been combined with other forms of Autism into a general category of Autism Spectrum Disorders. However, there is still some contention about this, and many people with Aspergers prefer the label to Autism.

Unfortunately, the diagnostic criteria for Asperger’s is based on a presentation that is much more common in males. Females with Asperger’s tend to be more socially adept. Like their male counterparts, they frequently make social mistakes and are easily overwhelmed in social situations. However, unlike their male counterparts, females on the spectrum tend to be much more socially motivated. Because of this, they tend to learn how to fit in. They are careful studies of social interactions and have learned to copy social behavior. However, because they are essentially faking social competence, it takes a lot out of them. They become easily overwhelmed and tend to isolate for long periods of time or get hyperfocused on specific interests as a manner of coping with anxiety and an over-sensitive nervous system.  However, also unlike their male counterparts, females with Asperger’s tend to have more  

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The Feelings of Power and Shame Being an Escort: by Ashley B.

Maybe what makes me the most connected to the rest of humankind is the feeling I constantly have that I’m so different and disconnected. I’m aware enough of the world around me to know most, if not all, of us feel this way at some point. Still, I feel more different. Or different in ways that are less acceptable. Or maybe it’s just that I’m more honest than most people. I don’t feel the need to hide much and as a rule I don’t shrink away from facing hard things head on. When you’ve experienced the things I have, you kind of lose that deep need to be socially appropriate and you learn to live with the knowledge that running is futile. My first memory of life involves being lured into the room as my father was nude, drying off after his shower. He casually stole my 3 year old innocence as he talked me in to touching his manhood. There were multiple deaths and births in that moment. Shame sprung forth fresh and new, and continued to grow in me well into adulthood. In fact it contributed significantly to many of the choices I made, which I’ll explain more  

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Humor in a Therapeutic Setting: A Guest Blog by Jessica Levith M.A.

Make Em’ Laugh

The Power of Laughter in the Therapy Room

Jessica Levith, M.A.


Most of us had lives previous to becoming therapists. After undergraduate in San Francisco, I moved to Los Angeles where I undertook stand-up and comedy writing. I then blinked my eyes, nine years passed, and I was thirty. At my birthday lunch I watched an older friend, who by all accounts had “made it” as a comedy writer, whiskey-nurse his latest out-of-work ulcer. I decided that lunch to go back to school, but I never forgot comedy.


What’s So Funny?

It’s sometimes difficult to picture humor itself as an intervention, but I believe it can be a powerful way to connect with our clients. I openly invite humor into the therapy room, because it often feels like our expected seriousness as therapists paradoxically pushes away our client’s chance for deeper reparative emotional experiences. I chuckle when I think about the archetypal, uber-serious psychiatrist, Dr. Leo Marven, from the 1991 comedy film “What About Bob?” I wonder how safe his clients felt in session with him. He sets up a clear power differential with his cold, lawyer-esque office to convey he’s there to “fix” clients.  

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Everyone Must Be Thinking How Wonderful I Am: Guest blog by Melodie Ayres

I hate to share feelings unnecessarily, but maybe I should open up a little bit more about one of the greater reasons why I started this project: loneliness. I am so lonely I can hardly stand it. For the time being, I’ve moved past my desire for a significant other, and am solely focusing on the need for friendship. I’ve moved around so much in my life that I have no “core” group of friends. I go through phases of really making an effort to invite people places and/or forcing myself to participate in social gatherings, in an attempt to create this circle of friends. Then somewhere along the way, I get discouraged, or busy, or…self-centered. I find that when I’m lonely, I tend to only see my needs, which in turn, isolates me even more, because I can’t see past myself. Make sense? It’s a horrible cycle. And I don’t have the solution. It’s a fight to stay positive, but I know that turning my gaze inward will not lead me anywhere good. Thus, this project. I figure, if I can turn my attention outward, towards others, and their needs, and not on myself, that surely, a change will  

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Hospitals, Self-Harm and Other Subjects: A guest blog by Jamie Casbon

Here’s a little trigger warning: depression, suicide, self-harm, that business. It’s how I roll.   Also,  I’m  trans male, this happened years before I transitioned. I considered myself female at the time and realising I was male was a gradual process that began about 4 yrs ago. My hospitalisation didn’t have anything to do with my gender identity.

This story starts the beginning of second semester in undergrad. I had just come back from an un-fun Christmas visit in Texas, the location of one of the worst times in my life. It wasn’t Texas’ fault, really, just bad timing. In addition to having to visit a place with a lot of difficult emotions tied to it, I also stayed for what seemed like two weeks (including New Year’s) when I can barely handle about 6 days with my parents. Bad idea on top of bad idea on top of bad idea. When I got back home to New York, I almost immediately fell into a hole.
The first inkling I had that things might be bad was the second or third day I was back. I stayed in one of my friend’s dorm rooms with our tight group, getting fucked  

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Mental Health after Disaster: A Missed Opportunity in Bangladesh – A Guest Blog by M. Sophia Newman

It was the end of April. Police had stopped transportation on the busy road leading to Savar; a stream of people walked along the hot, dusty road. We were all going to the same place: the site of the former Rana Plaza factory. Days before, on April 24, 2013, it had collapsed with over 3500 workers inside. Now, six days later, the rescue operation had dwindled to the recovery of the 1,116 bodies in the wreckage. Nonetheless, onlookers streamed to the site. Some protested or brought donations. Others just came to witness the worst industrial disaster in the history of Bangladesh.

Outside the factory, women holding pictures of missing loved ones wailed. As a rare foreigner, they targeted me for attention, begging me to do something. I hugged two, one under each arm – and when a camera crew noticed, I was suddenly on live TV. A journalist asked in English what I thought should be done. “These people need access to mental health care now,” I said.

I knew my words were in vain. I had come to Bangladesh months before as a Fulbright research fellow to study the mental health system – or, to phrase it more accurately,  

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What’s the Difference Between “Therapist”, “Psychologist” and “Social Worker” – Guest Blog by Matthew

Hi Paul,

As a social worker who works full time as a psychotherapist in New York City, I had a thought about something that could really use some clarification in the world of mental health care.

“Social worker” can mean a person with a bachelor’s degree in social work (BSW), a master’s degree (MSW), or a doctorate (DSW or PhD). Each of these degree levels qualifies you for a different kind of work:

–  A BSW can practice as a “generalist”, such as doing crisis intervention, or interviewing, or case work (like your guest, Ray). A BSW cannot, in any state, practice psychotherapy.

–  With an MSW, you can choose to specialise in clinical practice – like a psychologist specializing in clinical psychology – which entails additional supervised training in diagnosis and treatment of mental disorders. Social workers must be at this level of education and training to become licensed therapists.

– A doctoral degree (sometimes called DSW, sometimes called PhD in Social Work) does not give you more clinical authority, but does give you additional qualifications for research and teaching in the field of social work.


This is from the web site of the National Association of Social Workers:

“Did you  

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Are You In An Unhealthy Relationship? Guest blog by Maddy (The Great White Oprah)

1. Is my relationship abusive or unhealthy?
-Firstly, if you’re asking this question, that’s a clue. If someone asks you if you feel safe in your relationship and you can’t immediately, uninhibitedly say yes, that’s a problem.
-An abusive partner will separate you, if not isolate you completely from your family or friends. There could possibly be an ultimatum, verbalized or otherwise, a threat about what might happen if you decide to hang out with anyone else. The more time you spend with friends and family, the less power your abuser has, so they don’t want that.
-An abusive partner will invalidate your feelings or reactions in order to maintain control. Phrases to look out for include but are not limited to “are you STILL upset about that?” “Why can’t you just let it go?” And “we were having such a good time, don’t ruin the good times we have.”
-It should also be stated that the best abusers will not be all bad, otherwise they’d have to get new victims more quickly. My abuser cooked for me, took care of me when I was sick, drove me to surgeries, held my hand at the dentist. These positive experiences make  

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What is Disorganized Attachment? – A guest blog by Joel Schwartz PsyD

Disorganized Attachment – An Explanation for Non-Clinicians

Many clients who end up in the therapeutic chair or couch are impacted by a disorganized attachment style. Disorganized attachment serves as a diathesis (risk factor) for many difficult psychological syndromes including depression, dissociative disorders, various personality disorders (especially Borderline and Narcissistic Personality Disorders), PTSD, and Complex PTSD. I have found it useful to explain the etiology and manifestation of disorganized attachment to my clients as a way to begin understanding their confusing and dysfunctional coping methods and behaviors. However, my search of the web has yielded little information for the non-clinician. As such, here is my jargon free explanation:

Usually, when infants and young children are frightened or sad they approach their parent or caregiver for safety and comfort.  When the parent or caregiver is able to empathize, soothe, and care for their children, it teaches them how handle their own uncomfortable emotions and be caring and empathic for others. They also learn healthy boundaries and know how to seek out and rely on others for help.  This is the basis of healthy interpersonal relationships and is called “secure attachment.”

However, when parents react to their children’s efforts to receive comfort, empathy,  

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