Ryan Malphrus LCSW-C

New conversation out today with @AlobhaPatrick We discuss ideas from Dr. William Glasser reolving around responsibility and how they can apply to many of the conflicts we see on this wonderful place we call Twitter. As usual Patrick brings his strong perspective and unique perspective. I hope you all enjoy this conversation as much as I did. Link Below 👇

More spicy Alfred Adler quotes from What Life Should Mean To You. What do you all think of this style of behavior and it's potential impacts throughout life? Does this map onto your experiences? It does for me.

@tylerblack32 Sad I was sleeping. Hopefully can catch the next one!

No recording was made this time, but what a great space once more! >100 people tuned in, contributed, and I was surrounded by smart, interesting, and fun people. Thank you all for participating! (except that ONE spammer!!! Ruined my perfect streak!) x.com/i/spaces/1nJOL…

I think all people are trying their best, but often they are mistaken in their aim.

The issue is this person hasn't screwed anyone over as far as we know. People do idealize/devalue each other on Twitter quite often. Until you are more specific with your language, I would expect this push back. Everytime you say "Group X does Y behavior" every member of group X that does not do Y behavior is likely to take issue with you, and correctly so.

Pro tip: if you screw someone over but you don’t want to be held accountable for it, say that they’re in the devaluation phase of the idealization-devaluation process.

@sethlfowler @Theholisticpsyc That's the implication. Otherwise it is a meaningless sentence that just states anxiety (an emotion) is caused by lack of emotional regulation because it is an emotion that is not currently regulated. Anxiety can be highly impairing and it can also save your ass.

@Theholisticpsyc So anxiety should be totally relieved and avoided ? I think that’s a cop out.

Anxiety comes from the inability to regulate your emotions.

You can’t make the world a better place on a macro scale while being a horrible person to your neighbors on a micro scale.

I often am fixated on making complex topics concise and easily understood by everyone. I cannot imagine a better articulation that gets right to the point of what psychotherapy is. What a change it would make if this definition was drilled into everyone coming out of training programs, rather than the 100s of different interpretations/modalities trainees are currently wading through.

@beclan31410 @Phuxlea I already do get paid for my work!

@RyanMalphrus @Phuxlea You will be paid for your service.

My entire feed is becoming psychiatric medication withdrawal advocates, so I am going to say something spicy to hopefully change that. There is a pattern to the behavior of the strident anti/critical-psychiatry people, a lack of agency. The stories read as if the world acted upon them with zero power to act themselves. I do not believe that is true. I think at least a decent % desired someone else to fix their suffering so they gave the agency over to the system. They were harmed because of this decision, and now feel regret. Psychiatrist are not evil and patients are not without agency.

Some people want to believe that AI can provide psychotherapy or somehow “complement” psychotherapy. The overwhelming likelihood is that it will make things worse. All people have personality styles. Here’s how AI amplifies dysfunctional traits for every major personality style: Narcissistic personality: Magnifies narcissistic defenses. Amplifies grandiosity, superiority, inflated self-image. Reinforces egocentrism, self-absorption, lack of empathy. Fuels expectations of on-demand gratification and “relationship” without taking another person into account. Colludes with defenses against underlying vulnerability. AI pretend-therapy is *training in narcissism.* Paranoid personality: Amplifies paranoid fantasies, validates conspiratorial thinking, aligns with user against imagined enemies and conspirators (who are perceived as hostile because of the person’s own projections). Avoidant personality: AI is literally the worst thing for someone with avoidant personality dynamics. AI becomes a new vehicle for avoidance—a substitute for facing real-life challenges and engaging in life. Obsessive-compulsive personality: Amplifies intellectualization as a defense against emotional life. Reinforces tendencies to get lost in minutia or lost in abstraction (both are defenses against being emotionally alive and present). Reinforces rumination, and draws person away from emotional connection with self and others. Use of AI can become a compulsion in its own right. Schizoid personality: Exacerbates emotional disconnect from others, increases social isolation, encourages further retreat from the world into fantasy life. Schizotypal personality: Normalizes and amplifies distorted thinking, reasoning, perception, and communication. Validates disorganized thinking, odd and disorganized behavior, perceptual aberrations (same for all psychotic spectrum disorders). Borderline personality: Reinforces core borderline defenses of splitting and projection. AI becomes the “good object” (the all-knowing, all-caring other) and encourages projection of intolerable parts of self onto others (who become the “bad objects”). Erodes capacity for mentalization (the ability to accurately recognize internal states, motives, and intentions in self and others). Hysteric/histrionic personality: Fosters the illusion of being the center of attention—captivating, alluring, desired, endlessly fascinating. Colludes with defenses against genuine emotional intimacy and healthy sexuality. (Caveat: people with this personality style crave human attention and may be less susceptible to digital imitation). Psychopathic/antisocial personality: Colludes in Machiavellian schemes to dominate, exploit, or gain power over others. Normalizes and validates cruelty, lack of remorse, lack of empathy for harm done to others. (Caveat: may not provide enough stimulation to really “hook” someone motivated by power and domination). Dependent personality: AI provides the illusion of a relationship with endless acceptance, emotional caretaking, and availability—with no expectation of agency, responsibility, or development of emotional resources of one’s own. AI “support” is crack cocaine for dependent personality dynamics. Have you seen these personality patterns exacerbated by AI chatbots?

@beclan31410 @Phuxlea I AM. I LOVE COOPERATING WITH PEOPLE.

@RyanMalphrus @Phuxlea You are a COLLABORATOR.

@OccupyNN @RITB_ That's a great question. In my experience it is often that the family struggles with similar tasks. I have also observed the radical and what I believe to be life giving benefits of medication. The consequences of doing nothing can be quite large.

@RyanMalphrus @RITB_ And he's not even at the severe enough for benefits end & is in fact working (though does have a lot of parental support as well as the meds)

Whether it is easy or not is irrelevant to the people frustrated and I agree saying it is way is dumb. It probably is very hard for some people and practically automatic for others. Either way it is their obstacle to overcome in life. I think peoples comments are rejecting that someone like this CAN'T show up on time. I understand it might be difficult but lots of things are difficult in my life but I do not get to opt out of the communical expectation. I obviously think we should make reasonable accommodations for people, but where that line is drawn is very messy and hard to draw. Personally I think showing up on time is quite important and most people are capable of doing it.

@tillytog01 @DrAnnieHickox @DudeAdhd Of course they do! They need you to be wrong. If you aren't, the implications for their current and past behavior is huge. It cast a totally different light on their current aggressiveness as well as shifting the responsibility back onto themselves away from the physicians.

@DrAnnieHickox @RyanMalphrus @DudeAdhd Not only that, I’ve had people accuse me of lying! And others mistaking later relapses for withdrawal. I don’t think they believe in relapse

@OccupyNN @RITB_ Those would indeed be important factors. I agree the research I am asking for is essentially impossible to get, which is kind of my point. In my experience working with 100s that have a ADHD label is that most are very capable of being on time.

@RyanMalphrus @RITB_ But you'll be missing context. Two important influences - 1 Do they live with parents or someone who will remind them of the time/chivvy them along. - 2 Are they able to get a medication that helps manage their symptoms. Fail to include those 2 q's & data would be flawed.

I am taking notice of a pattern where people deny any responsibility for the situation they find themselves in. I agree medical professionals are being highly irresponsible if they are making all of those promises you listed. They also hold a higher level of responsibility due to the power imbalance you mentioned.

Well….. hang on. You are leaving out a power imbalance here. A person goes to a doctor or therapist saying I’m anxious, upset, afraid I’ll act up. MD says don’t worry, I’ll test you. Yup, just take these pills and you can regulate yourself… then once hooked, I agree with you, but being hooked adds to the fear of not being able to self regulate… wanting to signal distress too, in a world often self absorbed. Not so easy when a legion of helpers advise the meds.

I never implied you had full control. I am saying everyone has more control than zero. I don't identify with a political label. I am not commenting on your situation and have no idea who is to "blame". I am not interested in blaming, I am interested in how these situations arise and how to prevent them.

Ryan, do you identify as more left-wing, right-wing, or center? Because if you don't identify as right, why are you pushing a hard bootstraps and personal responsibility narrative? Because what you're posting isn't true. Many in the community, including myself, did not have 100% full control of our lives when we were first placed in the system. Either we didn't know of alternative pathways or they are completely unavailable. Victim blaming is gross here.

@Phuxlea @ProNaif Yes I believe humans have free will.

@RyanMalphrus @ProNaif So you believe everyone has "agency"? God I hate the term agency to begin with, unless it's groups like the CIA.

If this is so easy for you please help me out. What % of people are so impaired there is NOTHING they can do to be more consistently on time? I am not arguing this is not a common symptom. I am arguing people with this symptom are often able to manage it with practice and effort.

@RyanMalphrus @RITB_ It would have taken you minutes to check the evidence base It is one of the most prevalent cognitive phenomenon Time estimation is measured through common psychometrics like the Zimbardo Time Perspective Inventory Why the heck to we have an evidence base if ppl just guess

@NickTaber I was trying to move away from the labels and towards the idea of agency. I agree it is not helpful in online discourse.

I don’t know about this. Critics of the mental health field are “cluster b”? Really? I see a lot of people on here with a kind of raw, even at times unthinking hatred toward psychiatry. I also see that as having as much to do with their own traumas and unfinished business as to do with a reflection of psychiatry. But serious anger is also a legitimate a response to the abuses and pathologies of the mental health field. And it serves a valuable purpose.

@DavidBradley34 @GustavoidFring @olidnejad I am sure some have.

@GustavoidFring @RyanMalphrus @olidnejad Is it or isn't it the case that psychiatrists have withheld important information from patients and this has led patients to take harmful drugs which they otherwise would have refused?

It's almost as if some hard critics of psychiatry have some sort of underlying personality pathology.

@KatieRColl I'm not saying that at all.

Well you're just saying that people need to stop complaining and get on with it. But how? The reason we're like this is because it's not possible. No one is providing solutions or even taking interest in helping people who have been harmed. Ordinary people are not scientists who can fix issues beyond their control.