All posts by johnsommersflanagan

Personal Reflections

Free Speech, Hate Mail, and My New Love for ChatGPT

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[Me talking with an early version of AI]

Being inclined to express my opinion across a variety of formats—in person, in newspaper op-ed pieces, online, and in this blog—I’ve received a smattering of hate mail over the years. My first hate snail-mail experience was around Y2K. I had an every-other-week column in the Missoulian newspaper. Whenever I wrote anything positive or promising about girls or women, or anything opposed to physical abuse, I received a 2-3 page single-spaced anonymous letter/rant from an anti-fan. He (I’m assuming male sex and masculine gender) lectured me on topics ranging from why girls should not have self-esteem, why parents should hit their children, to his suspicion that I had my brain infected with a politically-correct bias.

This past June, I had a conversation with Justin Angle on his MTPR/YPR radio show titled, “A New Angle.” The topic was “Good Faith.” Justin was an excellent interviewer. We talked so much he made our conversation into two shows. You can listen to part 1 (where I make my offending comment) here:https://www.youtube.com/watch?v=aSVtWocnLXg

And part 2 here: https://www.youtube.com/watch?v=FwTc7TfUKaM

After the first show, I received a hate email. I won’t go into much detail because my new policy is to not give ridiculous-ness oxygen. Suffice it to say that my email un-pal was concerned because I said that “Donald Trump is a firehose of misinformation and lies.”

Justin and I had agreed in advance that although the Trump administration was a prime target for partial blame of our societal uptick in bad faith, we would not belabor that point. Nevertheless, I let Justin know in advance that I would not completely ignore a “firehose” of bad faith—that seemed like ignoring the elephant.

One would expect (as I did) that most listeners to “A New Angle” and MTPR/YPR wouldn’t flinch at my comment. I made a point not to be political. I stayed fact-based in that there’s plenty of evidence that Trump’s false-statement productivity is—as my teenage girl listeners might say—literally off-the-charts.

Surprisingly, my new email un-pal disputed that Trump lies at all. He went on to share ways in which Trump is saving America. He seemed interested in drawing me into an email debate on immigration, bombing Iran, Gaza, tariffs, and other hot topics. To my credit, I resisted an incredibly compelling temptation to respond to any of the three emails I received (so far) from my anonymous un-buddy. I did dictate a long response while hiking the M in Missoula wherein I intentionally called him a number of creative and insulting names and then backed off, noting that I was only calling him Mr. “Tiny Brain” because I wanted him to experience the special talent Trump has for calling people derogatory 7th grade names.

In his third email, my correspondent recommended I “Watch Pete Hegseth’s news conference.” In response, I vomited, hit delete, and thanked the Lord for self-control.

But I digress.

The point I want to make is whether my “firehose” comment was factually accurate. To objectively evaluate my veracity, I decided to consult with ChatGTP. I used the following question: “Does Donald Trump lie?”

Here’s what ChatGTP said (in italics):

*********************************

Yes, Donald Trump has made many statements that have been fact-checked and found to be false or misleading.

Independent fact-checking organizations such as PolitiFact, FactCheck.org, and The Washington Post Fact Checker have documented thousands of inaccurate or deceptive claims made by Trump during his presidency and political career. For example:

  • The Washington Post reported that Trump made over 30,000 false or misleading claims during his four years as president.
  • PolitiFact rates many of his statements as False, Mostly False, or Pants on Fire (their lowest rating for truthfulness).

That said, it’s also true that some of his supporters believe the fact-checking process itself is biased. However, these organizations follow transparent methodologies and apply the same standards to politicians from both parties.

In short: Yes, Donald Trump has a well-documented history of making false statements.

*********************************

Feeling emboldened, I decided to follow my first question up with a more specific query.

“Is Donald Trump a firehose of misinformation and lies?”

*********************************

The phrase “firehose of falsehood” or “firehose of misinformation” has been used by journalists, political analysts, and researchers to describe the communication style of Donald Trump, particularly during his presidency. This term refers to a propaganda technique characterized by:

  • High volume of messaging
  • Rapid and continuous output
  • Repetition of falsehoods
  • Lack of concern for truth or consistency

Origin of the Term:

The “firehose of falsehood” model was developed by researchers at the RAND Corporation to describe Russian propaganda, but scholars and journalists (e.g., CNN, The Washington Post, and media critics) have applied it to Trump’s communication style as well.

Evidence Supporting This Description:

  • Fact-Checking Data: As noted, The Washington Post documented over 30,000 false or misleading claims by Trump during his presidency.
  • Repetition: Trump has frequently repeated disproven claims (e.g., about voter fraud, crowd sizes, COVID-19 treatments).
  • Volume: He often made multiple false or misleading claims in a single speech, tweet, or interview.

Expert Opinions:

  • CNN and other outlets have explicitly described Trump’s strategy as a “firehose of falsehood.”
  • Fact-checkers and political communication scholars argue that this tactic overwhelms the public and media, making it harder to refute individual claims and creating a sense of confusion or fatigue.

Summary:

Yes, many credible observers and analysts have described Donald Trump as using a “firehose of misinformation and lies” approach. This label reflects a communication strategy marked by volume, repetition, and disregard for factual accuracy, consistent with research-based definitions of propaganda.

Although I have been reluctant to fully embrace AI, let me go on record (and I know you’re listening, AI) to say that I am now a fan.  I am AI-affirmed. Thank-you, ChatGPT for supporting the accuracy of my public statement. Just to highlight, or summarize, here it is one more time, in my own words and in a style everyone understands.

DONALD TRUMP IS A FIREHOSE OF MISINFORMATION AND LIES.

culture, Happiness, Parenting, Personal Reflections, Writing

On Good Faith: A Conversation with Justin Angle.

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Last week I got a little hate email.

Some weeks are like that. I’d share the details, but that would spoil the surprise. Besides, I’m really not into giving hate email (or hate mail or hate social media posts) any oxygen.

But today I got an email alert from “A New Angle” the radio-podcast show hosted by Dr. Justin Angle, a professor in the College of Business Administration at the University of Montana. The email was alerting me to the imminent airing of Part 2 of my discussion of “Good Faith” with Just on his renowned radio show. I was grateful for the alert; it also reminded me of my hate email, because the hate email came from someone who listened to Part 1 of our Good Faith conversation and consequently felt that special sort of inspiration that moves people to write hate emails.

I’ve known Justin from a distance for a while. We’re both at the University of Montana, so, you know, there’s been a little chat here, a little chat there. I’ve also known of him growing his small podcast into a big deal on Montana Public Radio and Yellowstone Public Radio. Justin’s show is excellent.

What I didn’t know is the depth and breadth of Justin’s intelligence. I also didn’t know that he’s a fabulous interviewer. I discovered his amazing intelligence and fabulousness when I sat down with him this past May to record a show with him on Good Faith. We talked comfortably for what felt like a long time. Not only did it feel like a long time, it was a long time! It was so long that Justin turned our conversation into a two-part episode for his radio show.

Here’s the email I received:   

This week is part two of our conversation with John Sommers-Flanagan, director of the Center for the Advancement of Positive Education at the University of Montana’s Phyllis J. Washington College of Education.

John and Justin pick up where they left off last week talking about how lying and parenting intersect, the concept of confirmation bias and the risks of AI-generated content and building relationships with AI.

Here’s a link to Part 2 of our conversation. It’s also live at 7:30pm tonight (Thursday, June 19, 2025) on Montana Public Radio:

https://www.anewanglepodcast.com/p/good-faith-with-john-sommers-flanagan-954

If you want to listen to Part 1 and possibly feel inspired to send me a hate message, here’s that link:

https://www.anewanglepodcast.com/p/good-faith-with-john-sommers-flanagan

As always, thanks for reading and have a fabulous day.

Happiness, Love, Parenting, Personal Reflections, Writing

Peggy Bit Me . . . and Then She Wrote a Children’s Book

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Version 1.0.0

To prevent confusion and conflation, I should note that the title of this blog post represents two separate events:

  1. In 1958, Peggy bit me.
  2. Then, in 2025, she wrote a children’s book.

Just so you know, the 2025 children’s book is NOT about that time she bit me. I’m hoping that will be her second book because I’d really love to get to the bottom of what the heck 3-year-old Peggy was thinking right before she tried to bite off my big toe. My guess it was something like, “I’ll show that chubby, whiny infant baby John a thing or two; he’s not bumping me off my youngest child throne. And if he does, he’ll be limping all the way, because he’ll be missing a toe.”

But I digress. This post is about my wonderful sister’s wonderful new children’s book. I don’t want to make a big deal about my toe injury. The “toe incident,” which people are now calling it, although still emotionally painful for me, is ancient history. Although initially a wild-rabid-feral child, my sister Peggy has grown into a gentle, kind, creative, smart, compassionate, and amazing woman. She would never bite my toe again. Right Peggy?

Peggy’s book is titled, “Catching Memories.” It’s about a unique childhood experience she had with our family (with Gayle and Peggy’s favorite brother, John, as key sibling figures), at Arch Cape, a beautiful beach on the Northern Oregon Coast. We spent many weekends at Arch Cape, as it was our maternal grandparents home.

The specific memory Peggy writes about was SO GOOD. I’m not sharing details. You’ll have to pay the big bucks, $14.99 on Amazon, to read the story. Here’s a link. Buy Catching Memories

Peggy just sent me a copy of an INCREDIBLY POSITIVE Falcon Review of her book. The review is great, because the book is great. I’m guessing Peggy did not bite the toe of the reviewer. I say this because right now I’m typing a great review and hoping Peggy will take notice:

“Catching Memories is a fabulous children’s book about a unique family experience, memories, and kindness. Peggy Lotz’s debut children’s book is written with so much love, affection, and grace that you would never suspect she tried to maim her younger brother. The book is so awesome that you’ll want a copy for your children or for yourself or both. Buy it now”

In case Peggy is reading this, I’m trying to make it clear that even though that Falcon Review guy wrote you a great review, I’ve just written and posted a rather fantastic review . . . AND you (Peggy) bit me. This fantastic review should make it clear that I’m better than that Falcon Press guy could ever hope to be . . . because the fact that I’m writing it for someone who bit me speaks to the sort of selfless and forgiving person I am. In summary: My sister bites my toe and I put aside the pain and write her a stellar review. If I haven’t made it obvious yet, I’m campaigning for the position of being Peggy’s favorite brother. Given that I’m her only brother, I have the inside track, but you can’t mess around with favorite brother stuff because one day, just when you think you’re on top of the world, the next minute your big sister might try to gnaw off your big toe with her big teeth.

All I’m saying here (Peggy), is that I’m your favorite brother. Forget about that Falcon Review guy. He’s not your brother. . . let alone your favorite!

In closing, if any of you care about me, please show it by buying a copy of my sister’s book.

Buy Catching Memories

P.S. Here’s the best thing. Peggy says there’s a chance that the marketing plan might involve creating “Gayle, Peggy, and John” dolls. . . which is simply the coolest idea ever.

If you’re curious about the original “Peggy Bit Me” story, just click here: https://johnsommersflanagan.com/2019/01/28/peggy-bit-me/

Happiness, Personal Reflections, Research

That Time When I Found A Parallel Universe Where People Like Statistics

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Earlier this week I found a parallel universe wherein I was able to convince three people that it would be terribly fun to sit with me in a classroom for 2+ hours and work through the post-course data from our most recent “Happiness for Educators” class. This involved me figuring out how to screencast my computer onto a big screen where I went through the process of accessing our Qualtrics file and exporting the data to SPSS. Then, while experiencing intermittent fits of joy, we cleaned the data, used the “recode” function to reverse score all the items requiring reverse scoring and then calculated our 16 different outcome variables.

In this parallel universe, the three people who joined me (you know who you are), asked great questions and acted interested the WHOLE time. Of course, one of the “people” is a well-established Missoula actor, so there’s the possibility that I was fooled by some excellent acting or feigning or pretending. That said, finding a parallel universe where people act interested in stats remains a feat to brag about.

We made it through all the post-test data. To maximize the fun and bring us all to a place of breathless excitement, I ran a quick descriptive analysis. At first glance, the data looked okay, but not great. Of course, we didn’t have the pretest outcome variables analyzed, and so we were forced to leave with bated breath.

Today, access to the parallel universe was briefly adversely affected by a slight temporal shift; nevertheless, I found one of the “people” and she enthusiastically embraced another 2 hours of stats. . . . At the end, she shouted from her office, “That was fun!”

I know at this point, I am, as Freud might say, “straining your credulity” but I speak the whole truth and nothing but the truth.

And the rest of the truth gets even better. Tammy (my new best stats friend) and I found the following statistical results.

  1. 89 of 100 students completed the pre-post questionnaires.
  2. We had statistical significance on ALL 16 outcomes—at the p < .01 level (or better).
  3. The effect sizes (Cohen’s d with Hedges adjustments) were among our best ever, with top outcomes being:
  4. Improved positive affect (feeling more cheerful, etc): d = .900 (a LARGE effect size)
  5. Reduced negative affect (feeling fewer negative emotional states) d = 885. (a LARGE effect size)
  6. Improved total self-reported physical health (a compilation of better sleep, reduced headaches, reduced gastrointestinal symptoms, fewer respiratory symptoms) d = .821 (a LARGE effect size)
  7. Reduced depression (as measured by the CES-D): d = .732 (an almost LARGE effect size)

If you’re reading this, I hope you’re skeptical. Because if you’re skeptical, then I’m sure you’ll want to know whether this is the first, second, third, or fourth time we’ve found this pattern of results. Nope. It’s the FIFTH consecutive time we’ve had all significant outcomes or nearly all significant outcomes that appear to be happening as a function of our happiness for educators course.

Although I am in constant fear that, next time, the results will be less impressive, I’m getting to the point where I’m thinking: These results are not random error, because we now have data across five cohorts and 267 teachers.

If you’re reading this, I also hope you’re thinking what I’m thinking. That is: You should take this course (if you’re a Montana educator) or you should tell your Montana educator friends to take this course. If you happen to be thinking what I’m thinking, here’s the link to sign up for our summer sections.

https://www.campusce.net/umextended/course/course.aspx?C=712&pc=13&mc=&sc=

It’s a pretty good deal. Only $95 to experience more positive emotions, fewer negative emotions, better physical health, reduced depression, and more!

Clinical Interviewing, Personal Reflections, Suicide Assessment and Intervention

My (Virtual) Visit to South Korea

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Last Friday night (or Saturday morning in South Korea), I had the honor and privilege of spending three hours online with 45 South Korean therapists. We were talking, of course, about strengths-based suicide assessment and treatment. Given my limited Korean language skills (is it accurate to say my language skills are limited if I can’t say or comprehend ANYTHING in Korean?), I had a translator. Although I couldn’t tell anything about the translation accuracy, my distinct impression was that she was absolutely amazing.

I had a friend ask how I happened to get invited to present to Korean therapists. My main response is that I believe the time is right (aka Zeitgeist) for greater integration of the strengths-based approach into traditional suicide assessment and treatment. The person who recruited me was Dr. Julia Park, another absolutely amazing, kind, and competent South Korean person, who also happens to hold an Adlerian theoretical orientation. Thanks Julia!

Just for fun, I wish I had my Korean translated ppts to share here. They’re unavailable, and so instead I’m sharing an excerpt from Chapter 10 (Suicide Assessment Interviewing) of our Clinical Interviewing (2024) textbook. The section I’m featuring is the part where we review issues and procedures around suicide risk categorization and decision-making.

You may already know that some of the latest thinking on suicide risk assessment is that we should not use instruments like the Columbia to categorize risk. You also may know that not only am I a believer in this latest thinking, I can be wildly critical of efforts to categorize suicide risk. . . so much so that I often end up using profanity in my professional presentations. Of course, because the context is a professional presentation, I only use the highly professional versions of profanity.  

Here’s a LinkedIn comment about that issue from Craig Bryan. Dr. Bryan is a suicide researcher, professor at The Ohio State University, and author of “Rethinking Suicide.” In support of him and his research and thinking, I’d like to professionally say that although I lean away from reductionistic categorization of things, all signs point to the likelihood that Dr. Bryan has a very large brain.   

The good news is that I feel validated by Dr. Bryan’s strong comments against categorizing suicide risk. But the bad news is that we all live in the real world and in the real world sometimes professionals have to do more than just swear about risk categorization—we have to actually make recommendations for or against hospitalization, consult with other professionals who want our opinion, and quoting me as saying that risk factor categorization is pure bullshit may not be the best and most professional option.

So . . . what are we to do? First, we parse Dr. Bryan’s comments. He’s not saying NEVER categorize risk or make risk estimates. He’s saying don’t categorize “negative screens as low risk” which is slightly different than don’t try to estimate risk. His message is that we have too many false negatives—where someone screens negative and then dies by suicide. In other words, we should not be confident and say negative screens are “low risk.” That’s different from throwing the baby out with the bathwater.  

It might be easy to think that Dr. Bryan’s comments are discouraging. But I view him as just saying we should be careful professionals. To help with that, below is the excerpt on Suicide risk categorization and decision-making, from our textbook. If you’re in a situation where you have to make a professional recommendation about suicide risk, this information may be helpful. BTW, the reason I was inspired to post this excerpt is because the Korean participants were wonderful and asked lots of hard questions, including questions related to this topic.

Suicide Risk Categorization and Decision-Making

Throughout this chapter, we have acknowledged the limits of categorizing clients on the basis of risk. The current state of the science indicates that efforts to predict client suicides (i.e., categorize risk) are likely to fail. Nevertheless, when necessary—because of institutional requirements or client inability to collaborate on safety or treatment planning—all clinicians should be able to use their judgment to estimate risk and make disposition decisions for the welfare of the client. As a consequence, we review a suicide risk categorization and decision-making model next.

Consultation

Consultation with peers and supervisors serves a dual purpose. First, it provides professional support; dealing with suicidal clients is difficult and stressful; input from other professionals is helpful. For your health and sanity, you shouldn’t do work with suicidal clients in isolation.

Second, consultation provides feedback about appropriate practice standards. Should you need to defend your actions and choices following a suicide death, you’ll be able to show you were meeting professional standards. Consultation is one way to monitor, evaluate, and upgrade your professional competency.

Suicide Risk Assessment: An Overview

We reviewed an overwhelming number of suicide risk and protective factors earlier in this chapter. Generally, more risk factors equate to more risk. However, some risk factors are particularly salient. These include:

Previous attempts

A previous attempt is sometimes viewed as suicide rehearsal. Two previous attempts are especially predictive of suicide because they represent repeated intent. Also, when previous attempts were severe and the client was disappointed not to die, risk is high.

Command hallucinations

When clients are experiencing a psychotic state accompanied by command hallucinations (e.g., a voice that says, “You must die’), risk is at an emergency level.

Severe depression with extreme agitation

The combination of depression and agitation can be especially lethal. Agitation can take the form of extreme anxiety or extreme anger.

Protective factors

A single protective factor may outweigh many risk factors. But, it’s impossible to know the power of any individual protective factors without an in-depth discussion with your client. Engagement in therapy and collaboration on a safety plan (and the hope these behaviors signal) can substantially reduce risk.

Nature of Suicidal ideation

As discussed earlier, suicidal ideation is evaluated based on frequency, triggers, intensity, duration, and termination. Some clients live chronically with high suicidal ideation frequency, intensity, and duration—and are low risk. However, if ideation is frequent and intense and accompanied by intent and planning, risk is high.

Suicide Intent

Suicide intent is the factor most likely to move clients toward lethal attempts. Intent can be based on objective or subjective signs. Objective signs of intent include one (or more) previous lethal attempt(s). Subjective signs of intent can include a client rating of intent or client report of a highly lethal plan.

Clinical Presentation

How clients present themselves during sessions is revealing. Clients can be palpably hopeless, talk desperately about feelings of being trapped, and express painful and unremitting self-hatred or shame. But if clients have adapted to these experiences, they may not have accompanying intent and active planning. Observations of how clients talk about their psychological distress will contribute to your final decisions.

Final Decisions

Using a traditional assessment approach, you can estimate your client’s suicide risk as fitting into one of three categories:

  • Minimal to Mild: Client reports no suicidal thoughts or impulses. Client distress is minimal. Plan: Monitor client distress. If distress rises, or depressive symptoms emerge, re-assess for suicidality.
  • Moderate to High: Client reports suicidal ideation. As client distress, planning, risk factors, and intent increase, risk increases. Plan: Manage the situation with a collaborative safety plan. Depending on client preference, engaging family or friends as support may be advisable. Make sure firearms and lethal means are safely stored.
  • High to Extreme: Client reports suicidal ideation, plans, multiple risk factors (likely including a previous attempt), intent, and has access to lethal means. Engagement in treatment is minimal to non-existent. Plan: Treatment may include hospitalization and/or intensive outpatient therapy with a safety plan implemented in collaboration with family/friends. Make sure firearms and lethal means are safely stored.

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As always, please share your thoughts in the comments on this blog.

Counseling and Psychotherapy Theory and Practice, Personal Reflections, Writing

Counseling and Psychotherapy Theories: The 4th Edition Revision is Underway

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At long last, we’ve begun work on revising our Counseling and Psychotherapy Theories text for its 4th edition. Over the past several weeks, I’ve been putting in an hour or two a day, chipping away on chapter revisions, reaching out to reviewers, and planning with our new and very exciting co-author, Dr. Bryan Cochran, a highly esteemed psychology professor at the University of Montana. If you’re reading this, I want you to know of Bryan’s awesomeness (and if you’re Bryan, I want you to feel the pressure of this public announcement of your awesomeness) [hahahaha!]

You all probably know that our Theories textbook is far and away the Theories textbook with the most hilarity. No doubt, this is a rather low bar, given that I can’t find any funny stories in any other theories texts. We view theories hilarity to be extremely important in a theories text, because reading many theories texts can parallel the proverbial experience of watching paint dry.

Bryan’s addition to the writing team will give us something we need—an expert in the LGBTQ+ domain, and someone with a talent for telling stories that are simultaneously engaging, informative, and fun to read. Right now, he’s busy writing a “Lenses” chapter (to be Chapter 2) to orient readers to important theory-related lenses like (a) Queer theory, (b) Critical Race theory, (c) Intersectionality, and more. I, for one, can hardly wait for his Queer theory quips.  

News Flash: In the past, I’ve put out broad calls for chapter reviewers. This time, I’m being selective and directly asking prominent theories experts to review chapters and offer guidance. Some examples: For the Adlerian chapter we’ve got Marina Bluvshtein (woohoo!) and Jon Sperry (wow!). For the Psychoanalytic chapter, we got Nancy McWilliams (amazing!) and Pratyusha Tammala-Narra (fantastic!).

If you happen to be a specific theories subject matter expert, you should email me at john.sf@mso.umt.edu to get in on the fun. Or if you have a prominent theories friend/colleague to recommend, have them email me.

As one last theories teaser, below I’m pasting a few excerpts from Nancy McWilliams’s 2021 article titled, “Diagnosis and Its Discontents: Reflections on Our Current Dilemma.” I love this article as it gives a glimpse into problems with contemporary diagnoses and how psychodynamic therapists use individualized assessment in ways to honor the real-life complexities clients bring into psychotherapy. The excerpts below are from her article, which is linked at the end of this post.

On Labeling

The idea that one is anxious (or depressed or obsessive) about something that has meaning is being lost. Fitting an individual into a category tends to foreclose exploration of what is unique to a patient; it especially prevents insights into unexpected aspects of a person’s psychology or exploration of areas that are felt as shameful – the very areas that are of particular value in planning and carrying out psychotherapy.

On the vexing ways in which patients think about themselves and their diagnoses

It used to be that a socially avoidant woman would come for therapy saying something like, “I’m a painfully shy person, and I need help learning how to deal better with people in social situations.” Now a person with that concern is likely to tell me that she “has” social phobia – as if an alien affliction has invaded her otherwise problem-free subjective life. People talk about themselves in acronyms oddly dissociated from their lived experience: “my OCD,” “my eating disorder,” “my bipolar.” There is an odd estrangement from one’s sense of an agentic self, including one’s own behavior, body, emotional and spiritual life, and felt suffering, and consequently one’s possibilities for solving a problem. There is a passive quality in many individuals currently seeking therapy, as if they feel that the prototype for making an internal psychological change is to describe their symptoms to an expert and wait to be told what medicine to take, what exercises to do, or what self-help manual to read.

On “chemical imbalances”

. . . viewing psychological suffering as a set of disorders that can be fixed or improved chemically can easily invite the obverse assumption that those painful experiences are ultimately caused by random or genetically based chemical differences among individuals. This is a false conclusion, of course, something like saying that because marijuana improves appetite, the cause of low appetite is lack of marijuana. But it is nevertheless a frequent leap of illogic – in the thinking of nonprofessionals and of some professionals as well – to ascribe much severe psychological suffering to a “chemical imbalance.” Such a construction tempts us to ignore all the painful other sources of psychological suffering, such as poverty, neglect, trauma, and the myriad ways in which human beings can injure each other psychologically.

On not overgeneralizing research findings/recommendations to unique patients

. . . consider patients at the extreme end of the obsessive-compulsive continuum, whose obsessions border on delusional beliefs, who suffer profound annihilation anxiety, who wholeheartedly believe they will die if they fail to carry out their rituals, and who regard the therapist with suspicion for not sharing their conviction – in other words, the subgroup of obsessive patients that Kernberg (1984) would consider as psychologically organized at the low borderline or psychotic level. My experience suggests that with this group exposure therapy not only fails, it demoralizes the patients, makes them feel like failures personally, and kills any hope they may have that psychotherapy can help. It also demoralizes therapists, who have been told again and again that exposure therapy is the treatment of choice for OCD. If they believe their teachers, such clinicians can easily conclude they are simply not good enough therapists.

If I’ve piqued your interest in “Diagnosis and its discontents” by Nancy McWilliams, here’s a pdf of the article.

Diagnosis and Its Discontents Reflections on Our Current DilemmaDownload

Stay tuned for more theories revision (we’re calling it T4) updates.

John SF

Clinical Interviewing, Counseling and Psychotherapy Theory and Practice, Happiness, Personal Reflections, Suicide Assessment and Intervention

Coughing My Way Through Montana

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Last week was a blur. On Wednesday, I did a break-out session for the Montana Prevent Child Abuse and Neglect conference in Helena. I’ve been to this conference multiple times and always deeply appreciate the amazing people in Montana and beyond who are dedicated to the mission of preventing child abuse and neglect. For the break-out, I presented on “Ten Things Everyone Should Know About Mental Health, Suicide, and Happiness.” This is one of my favorite newish topics and I felt very engaged with the 120+ participants. A big thanks to them.

Before the session, I felt a bit physically “off.” Overnight, the “off” symptoms developed into a sore throat and cough. This would NOT have been a problem, except I was scheduled for the hour-long closing conference keynote on Thursday. The good news is that I had zero fever and it was NOT Covid. The bad news was my voice was NOT good. I did the talk “In Pursuit of Eudaimonia” with 340ish attendees and got through it, but only with the assistance of a hot mic.

I had to cancel my Friday in Missoula and ended up in Urgent Care, with a diagnosis of bronchitis or possibly pneumonia, which was rather unpleasant over the weekend.

Having recovered (mostly), by yesterday, I recorded a podcast (Justin Angle’s “A New Angle” on Montana Public Radio) at the University of Montana College of Business. Thanks to a helpful pharmaceutical consult with a helpful woman at Albertsons, I had just the right amount of expectorant, later combined with a strong cough suppressant, to make it through 90 minutes of fun conversation with Justin without coughing into the podcast microphone. We talked about “Good Faith” in politics, society, and relationships. The episode will air in early June.

And now . . . I’m in beautiful Butte, Montana, where I’m doing an all-day (Thursday) workshop for the Montana Sex Offender Treatment Association. . . on Strengths-Based Suicide Assessment and Treatment . . . at the Copper King Hotel and Convention Center. Not surprisingly, having slept a bit extra the past five days, I’m up and wide awake at 4:30am, with not much to do other than post a pdf of my ppts for the day. Here they are:

SB SA for MSOTA 2025Download

Thanks for reading and thanks for being the sort of people who are, no doubt, doing what you can to make Montana and the world a little kinder and more compassionate place to exist.

Be well.

Clinical Interviewing, Counseling and Psychotherapy Theory and Practice, culture, diversity, Happiness, Multicultural, Personal Reflections, Research, Suicide Assessment and Intervention

Ten Things Everyone Should Know about Mental Health, Suicide, and Happiness

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I’ve spent the better part of the past two weeks doing presentations in various locations and venues. I did five presentations in Nebraska, and found myself surprisingly fond of Lincoln and Kearney Nebraska. On Thursday I was at a Wellness “Reason to Live” conference with CSKT Tribal Services at Kwataqnuk in Polson. Just now I finished an online talk with the Tex-Chip program. One common topic among these talks was the title of this blog post. I have found myself interestingly passionate about the content of this particular. . . so much so that I actually feel energized–rather than depleted–after talking for two hours.

Not surprisingly, I’ve had amazingly positive experiences throughout these talks. All the participants have been engaged, interesting, and working hard to be the best people they can be. Beginning with the Mourning Hope’s annual breakfast fundraiser, extending into my time with Union Bank employees, and then being with the wonderful indigenous people in Polson, and finally the past two hours Zooming with counseling students in Texas . . . I have felt hope and inspiration for the good things people are doing despite the challenges they face in the current socio-political environment.

If you were at one of these talks (or are reading this post), thanks for being you, and thanks for contributing your unique gifts to the world.

For your viewing pleasure, the ppts for this talk are linked here.

Ten Things Tex Chip April 2025Download