I have given multiple psychological evaluations for Department of Defense Consolidated Adjudications Facility in reference to security clearances.
Posted on Feb 7, 2022
Posted on Jul 11, 2022
A massive stressor to those living in the panhandle have been the hurricanes, including the Category 5 Hurricane Michael in 2018. Not only was the hurricane terrifying to endure, but the land and buildings from Port St. Joe to Panama City beach were flattened. "War Zone" was how many described the devastation. The broken landscape took years to repair, and still many are dealing with the aftermath of unrepaired, damaged homes. Almost as bad was the crime and exploitation that followed by inept, shoddy, and or even criminal contractors, and insurance companies that proved difficult and exploitive in their interactions with residents. The sense of fear, outrage, and betrayal--as well as living within a damaged infrastructure--seemed to translate, for many, into trauma symptoms. The fear of life, loss of community, and sense of being cheated while they were most vulnerable, seemed to have left many experiencing a range of anxiety, concentration, and mood problems. Lastly, the sense of being forgotten also has left an imprint. This psychologist's office was hit--though the walls and ceiling withstood the windblast. Meanwhile the residential home neighborhood was a wasteland, though inadvertently a good way to learn how survivors of hurricanes must deal with much more than the hurricane itself, including the stresses of managing afterward, helping friends and family, functioning with a damaged infrastructure, dealing with graft or exploitive contractors. PTSD material, really.
Posted on Aug 6, 2022
For many people with features of ADHD, either diagnosed, undiagnosed, or subclinical, the most troublese emotions is frustration. Frustration underlies many of the personality traits that develop with ADHD. Such frustration may arise from an impasse in their work, from having to wait in line, or making an error, and spikes quickly. The spike of frustration has a toxic feel, or may convert to depressed mood, which is why so many individuals with ADHD tend to become depressed , and over the long term, develop problems with self-esteem. Each time that frustrationn spikes, the individual's mood dips, and, worse, makes it more likely that frustration will again rise in the future. When I first worked with children, I noticed a high proportion of boys with ADHD were depressed--the presumption was that the highest demographic of depressed individuals was women. The boys, with a slightly higher proportion of the active type of ADHD, seemed hypersensitive to making an error. The goal was to help the child prevent the frustration, or, after the fact, to manage it. This meant reducing perfectionism, and the feeling of needing to rush. Methods also involved helping the child mentally taking a breath, or pause. Finally, a goal was helping the child learn cognitive ways of rehearsing cognitive ways of avoiding a descent into self critical or depressive thinking, every time they experienced frustration or setback.
Posted on Oct 1, 2022
Having "treated", or in other words, talked at length, sometimes for dozens of hours, with survivors of Hurricane Michael, I have a notion of what Hurricane Ian survivors might best do now. First, with damaged homes, be careful about unlicensed contractors. Insurance companies can also be tricky. Unlicensed or unscrupulous contractors, with no track record, or with no pre-hurricane history to check on, can make the trauma of the hurricane worst. Engineers, contractors, people who know a lot about construction are not immune to being taken advantage of. And get things in writing, or course. An established contractor who is licensed and has a good track record is as good as gold. Also, be aware that watching a hurricane from your house, or even re-entering an area that seems now worse than a war zone, can be traumatizing, and so having one's home, or even bedroom ransacked by tumultuous winds. And unfortunately, the hurricane does not always bring out the best in all. Check your bills to see that venders or temporary employment agencies are not overcharging. Talk with people about benefits from Fema. Do not be shy about contacting attorneys to protect your financial interests. And be aware that while there is great national interest in the hurricane at the moment, the rest of the country, or even friends located elsewhere, forget quickly, as news stories move on. Be a good neighbor because that make a big difference in the community.
Posted on Jan 6, 2023
To make an appointment
Posted on Jan 9, 2023
Client's are often very well informed. Having vast information at their fingertips, they sometimes seem to know as much as I do about an issue or diagnosis, and I have been practicing psychology for three decades. But there are problems in self-diagnosis. One is that some disorders mimic others. ADHD can look an awful lot like hypomania, or even the type of boredom a visual learner experiences when having to listen to unstimulating lecture. And then, what about PTSD--that can effect attention as well, and, further, ADHD is a risk factor for PTSD, so that both of them may exist. And then if there is bipolarity in the family there may be a hypomanic edge to the whole configuration. And what if the person has a gregarious or sociable personality, which also can be associated with high activity. That an mimic ADHD, even though it exists within the context of personality disorder. Sometimes context helps. Another problem are overused diagnosis. For example, the use of "narcissism." Some people seem narcissistic but really are just expansive because of a manic mood. And finally there is the issue of how personality intersects with clinical disorders. Depression in a person with avoidant personality is going to look different than in a person with compulsive features. A clinician saves time by getting the thing right-- though nowadays people are getting pretty good at it themselves.
Posted on Jan 30, 2023
Dad practiced medicine in RVC for 40 years and commanded a landing boat at Guadalcanal
Posted on Jan 31, 2023
Some diagnosis get missed all the time. I am not sure I am any better than anyone else noticing infrequent diagnosis, but being in the field long enough does alert you to some of thel less frequent diagnosis. So, a person may have a misdiagnosis and never seem to improve. The worst problem for a practitioner to miss is the prodromal phase of schizophrenia. The prodromal symptoms, often in late teens or early twenties, presage schizophrenia. Those symptoms can look like depression, anxiety or simply adolescent alienation. If it happens first year at college the issue is doubly problematic because the student's records are now shielded, the inquiring parent as seen as intrusive, and a college counseling center will generally miss it. And schizophrenia is the pancreatic cancer of mental health--an awful and debilitating disease. Another diagnosis not often detected is "atypical depression". This is is a varient of depression and responds to different medications. If a psychologist is providing testing to a physician, detecting this can enhance targeted treatment. Another common mistake is to diagnose inattentive ADHD in an individual who has what Russell Barclay has called "Sluggish Personal Tempo." Barklay is the guru of ADHD in the psychology world. These are children or adolescents who tend to be withdrawn, anxious, and sensitive and who meet some criteria for ADHD but really have quite a different disorder. Only superficially do they have ADHD symptoms.