Scott Smith LCSW

29/08/2026

What Makes Depression “Treatment Resistant?”

This restates and expands on my YouTube video:

28/08/2026

Doctors are finally learning to manage antidepressant withdrawal | New Scientist

Withdrawal symptoms following long-term SSRI use appear far more pervasive and serious than previously realised. Now medical bodies are rethinking how and when to stop taking them

Withdrawal symptoms following long-term SSRI use appear far more pervasive and serious than previously realised. Now medical bodies are rethinking how and when to stop taking them

25/08/2026

24/08/2026

A split in the spectrum? The ongoing battle to define autism

There is a continuing row over whether it matters if such a broad spectrum of people are defined as having autism

24/08/2026

We should begin psychotherapy with the end in mind: “In a major sense, any treatment is about ending it; it is about how to obviate the need for the therapist” (Schlesinger, 2014, p. 5). The therapist should be a guiding hand, not a heavy one. The aim of effective psychotherapy is to help the patient understand their personal barriers to change, clearing the road for the future. This is best accomplished by the therapist who directs the process of the work, as opposed to offering their personal views about the content (McWilliams, 2021). I have heard it said that in the story of a patient’s life, the therapist should be a footnote, not a main character. In the evergreen words of Donald Winnicott: “We all hope that our patients will finish with us and forget us, and that they will find living itself to be the therapy that makes sense.”

Psychotherapeutic Advice? Think Twice

Guest Post by Stephanie Foster

24/08/2026

Therapists say that “therapy-speak” has invaded their patients’ sessions and lives—and it’s making things difficult on everyone, Olga Khazan reported in 2025. https://theatln.tc/SGJZv553

“Gaslighting” and “love-bombing” are just two of the terms that couples therapists told Khazan their clients are misusing, typically after seeing descriptions of the ideas on social media. But according to the therapist Terry Real, no phrase is used as frequently as this one: “I’m the spouse of a narcissist.”

“True narcissistic personality disorder is marked by, among other traits, an abnormally high sense of self-importance and a lack of empathy,” Khazan explains. “And in reality, it’s very rare.”

Still, the therapists Khazan spoke with said that their clients seem very sure this unusual diagnosis must apply to their spouse. “People are incredibly confident in these conclusions and are not curious, are not open to discussing them and figuring out if they’re accurate,” another therapist told Khazan. “They’re coming in as the experts.”

“Most of the therapists I spoke with said they are glad that people are learning more about mental health,” Khazan continues. But “before the advent of social media, people picked up these ideas in self-help books, psychoanalysis, and pop culture.” Now, therapists say, too many people are getting sucked into online posts about pop-psych concepts—and they misapply them to their own relationships.

“Spouses’ attempts to diagnose each other can become a problem in couples’ sessions, these therapists said, because they distract focus from the dysfunctional patterns that both members of the couple are likely perpetuating,” Khazan writes. As one therapist told her, these labels can, in effect, say: “I’m not gonna change anything about our relationship. You have to change your personality or change all your behaviors to stay with me.”

But therapy-speak language appears to be here to stay. “‘I’ve got issues,’ which originated decades ago as a psychological euphemism for ‘I’ve got problems,’ is now so much a part of the lexicon that it no longer registers as originating in therapy,” Khazan writes. “Perhaps ‘gaslight’ and ‘narcissist’ are headed there too.”

📸: George Marks / Getty

23/08/2026

What We Must Lose and Mourn in a Successful Analysis: A List

We must lose to gain, and grieve to move forward.

23/08/2026

On Child Murder

How to safely hate a baby.

21/08/2026

“The question here isn’t whether ADHD is a real medical problem – it’s whether systems respond early enough, consistently enough and fairly enough to prevent avoidable harm … The real problems are long waits, inequitable access, inconsistent quality and too little joined-up support across health, education, care and employment.”

Rising number of people seeking ADHD diagnosis without treatment, say experts https://www.theguardian.com/society/2026/aug/18/great-adhd-myth-rising-diagnosis-without-treatment

Psychiatrists in Channel 4 documentary argue it is more a ‘social construct’ than a medical condition

14/08/2026

IN THE YEARS since the heat dome, scientists have pieced together a complex, composite portrait of how the average victim with schizophrenia came to be at such high risk of death. They were likely at home alone, in an older building that heated up easily and lacked mechanical cooling. They were less likely to have a social network to check on them. They likely avoided the news, so they didn’t know a heat wave was coming. When the heat wave hit, their body could not thermoregulate effectively, and antipsychotics further increased heat sensitivity. Even if they were aware of what their body needed, they didn’t feel comfortable going to a cooling center because they faced social stigma. And they didn’t feel safe interacting with the medical system because they’d had bad experiences in the past.

People with schizophrenia face a perfect storm of dangers on a hotter planet.