Former and current staffers paint a picture of an erratic senator who has become almost impossible to work for and whose mental-health situation is more serious and complicated than previously reported. No one is saying every controversial position (for example, his respectful relationship with Trump) stems from his mental health — but it’s become harder for them to tell which ones do. When I spoke with Fetterman in April and shared those concerns, he denied anything was amiss. He told me that he felt like the “best version” of himself and later texted that the staff turnover at his office was typical of Washington. “Why is this a story?” he asked.

Those first days in the hospital were rough. Fetterman was experiencing delusions. He thought that if he took a bed at the hospital, he would be arrested. He told doctors that he believed members of his family were wearing wires to secretly record him. In one chaotic moment, Fetterman grew convinced that a political rally was being held in the hospital’s lobby and that he needed to break out of his room to attend. David Williamson, Fetterman’s doctor, told me that the main causes of the delusions were the lingering effects of the stroke, dehydration, and depression and that the original medication for the depression could also have been a factor. According to paperwork from Walter Reed, doctors then stopped all antidepressants and put him on other drugs. (Williamson declined to comment on the specifics of the medication plan.)

After six weeks in the hospital, the doctors determined his mental-health issues were in remission. Williamson said, “He expressed a firm commitment to treatment over the long term.” Doctors provided Fetterman with a multi-faceted treatment approach. He needed to stay on his medication and to get his blood checked regularly. It was also important that he stay hydrated, so staff made sure his office fridge remained stocked with Gatorade. He needed to eat healthy and get regular exercise (this was both for his mental health and for the underlying heart problems that had led to his stroke). It was also strongly suggested that he stay off social media, which exacerbated his mental-health challenges. “I’ve never noticed anyone to believe that their mental health has been supported by spending any kind of time on social media,” he said in 2023.

it wasn’t until October 7 that it became clear Fetterman was the most outspoken Israel hawk in his party, offering constant and unconditional support for the military action in Gaza. Early on in the conflict, 16 of his former campaign staffers wrote a letter — anonymously — saying they found his full-throated support for Israel to be a “gutting betrayal.” Jentleson had taken to defending Fetterman on X from such criticisms, posting, “The thing about being a staffer is that no one elected you to represent them.”

In early November, just weeks after the attack, Gisele arrived at her husband’s Senate office and, according to a staffer present, they got into a heated argument. “They are bombing refugee camps. How can you support this?” the staffer recalled her saying with tears in her eyes. “That’s all propaganda,” Fetterman replied. Later, a still visibly upset Gisele pulled the staffer aside. She asked him if members of Fetterman’s team were pushing him to take these stances for political reasons. The staffer told her that the opposite was true: Many of them were as upset as she was. “If you’re pushing back on this, there’s no hope,” the staffer recalled her saying. “This is horrible news.”

Gisele might have disliked what her husband was up to, but his father loved it. Karl Fetterman, an insurance executive, was way more conservative than his son. He used to have a magnet on his refrigerator that warned that his dog bites Democrats, and he watched Fox News constantly. When Fox would air segments about Fetterman’s strong stances on Israel or invite him on as a guest, the senator’s father would, according to former staff, almost always call to say how proud he was.

Gisele then texted that she had told her husband that his staff and doctor were worried about him but that he told her “that’s not true and I guess I am not talking to you today” before hanging up. The doctor had also “said that he was fighting to get access of the Twitter account,” she went on. “Please promise me that he’ll never have access.” The staffer said that Fetterman was asking for the passwords but that he would not give them up. “I told him I don’t want to talk to him until his blood is tested,” Gisele wrote.

There was also the possibility that Fetterman’s illness had drawn out or intensified his existing predilections. In some ways, Fetterman was being the guy voters sent to Congress. He keeps to himself? He cancels fundraising events last minute? He thinks a lot of his colleagues are morons? Make him president already! He was never a particularly easy person to work with — he’d had that reputation throughout his entire political career. So sometimes the staff would debate whether a fundamental change had occurred or they were just imagining things, particularly since there were stretches of time when he was lucid and together. “It got hard to know which way was up,” Jentleson told me. “Was he acting crazy, or were we overreacting? I asked myself that a lot.”

Years after the stroke, Fetterman continues to struggle with auditory processing. To chat with me, he had put an iPhone on the table that transcribed my questions to him in real time. Sometimes Fetterman wouldn’t finish reading a question before answering, and other times his sentences could come out a bit garbled. After a podcast taping earlier this year with The Bulwark, the interviewer Tim Miller came away feeling like Fetterman might not be all there. “He’s struggling,” Miller said in a separate podcast taping. “He’s, like, really struggling. And I just think coming off of the Biden thing, we should not be hiding the ball on this sort of stuff.”

But in my conversation with Fetterman, I didn’t find any indication that the stroke had left him cognitively impaired. Our interview lasted just over an hour, during the first half of which he seemed excited to discuss just about anything I threw at him. He had problems with the way Democrats had estranged themselves from the public, he said, but still had no intention of leaving the party to become a Republican or even an independent: “Same chance I’m going to end up with a beautiful head of hair.”

He said that no one in his staff would know about his personal health situation and that anyone who told me otherwise was simply misinformed. “There’s not really anything to respond when that’s just not accurate,” he said. “What they say,” I pressed on, “is that they’ve witnessed ups and downs that could be associated with kind of a relapse. And they also worry that the medication that you’re on is not just for depression, but more serious drugs that if you’re not on them would be a problem. Is there truth to that?” “I don’t have any comment on that,” he said. “I’m going to go off record. Go off record. Go off record.” I cannot report what Fetterman said over the course of the next four minutes, but I can say that after he was done talking, I found myself in the hallway outside his office making awkward small talk with one of his press aides. Five minutes later, the door opened and I was ushered back in. The office felt different now. Quiet and tense. Fetterman was still in the same chair but slumped into himself, like a deflated parade float. His shoes were now on, and he avoided looking at me. Finally, I broke the silence. “Anything to say about that?” I asked, hoping to pick up our conversation where we had left off.

“Can machines be therapists?” is a question receiving increased attention given the relative ease of working with generative artificial intelligence. Although recent (and decades-old) research has found that humans struggle to tell the difference between responses from machines and humans, recent findings suggest that artificial intelligence can write empathically and the generated content is rated highly by therapists and outperforms professionals. It is uncertain whether, in a preregistered competition where therapists and ChatGPT respond to therapeutic vignettes about couple therapy, a) a panel of participants can tell which responses are ChatGPT-generated and which are written by therapists (N = 13), b) the generated responses or the therapist-written responses fall more in line with key therapy principles, and c) linguistic differences between conditions are present. In a large sample (N = 830), we showed that a) participants could rarely tell the difference between responses written by ChatGPT and responses written by a therapist, b) the responses written by ChatGPT were generally rated higher in key psychotherapy principles, and c) the language patterns between ChatGPT and therapists were different. Using different measures, we then confirmed that responses written by ChatGPT were rated higher than the therapist’s responses suggesting these differences may be explained by part-of-speech and response sentiment. This may be an early indication that ChatGPT has the potential to improve psychotherapeutic processes. We anticipate that this work may lead to the development of different methods of testing and creating psychotherapeutic interventions. Further, we discuss limitations (including the lack of the therapeutic context), and how continued research in this area may lead to improved efficacy of psychotherapeutic interventions allowing such interventions to be placed in the hands of individuals who need them the most.

Skeptics argue that many of the classic symptoms of the disorder — fidgeting, losing things, not following instructions — are simply typical, if annoying, behaviors of childhood. In response, others point to the serious consequences that can result when those symptoms grow more intense, including school failure, social rejection and serious emotional distress.

There are two main kinds of A.D.H.D., inattentive and hyperactive/impulsive, and children in one category often seem to have little in common with children in the other. There are people with A.D.H.D. whom you can’t get to stop talking and others whom you can’t get to start. Some are excessively eager and enthusiastic; others are irritable and moody.

Although the D.S.M. specifies that clinicians shouldn’t diagnose children with A.D.H.D. if their symptoms are better explained by another mental disorder, more than three quarters of children diagnosed with A.D.H.D. do have another mental-health condition as well, according to the C.D.C. More than a third have a diagnosis of anxiety, and a similar fraction have a diagnosed learning disorder. Forty-four percent have been diagnosed with a behavioral disorder like oppositional defiant disorder.

This all complicates the effort to portray A.D.H.D. as a distinct, unique biological disorder. Is a patient with six symptoms really that different from one with five? If a child who experienced early trauma now can’t sit still or stay organized, should she be treated for A.D.H.D.? What about a child with an anxiety disorder who is constantly distracted by her worries? Does she have A.D.H.D., or just A.D.H.D.-like symptoms caused by her anxiety?

The subjects who were given stimulants worked more quickly and intensely than the ones who took the placebo. They dutifully packed and repacked their virtual backpacks, pulling items in and out, trying various combinations. In the end, though, their scores on the knapsack test were no better than the placebo group. The reason? Their strategies for choosing items became significantly worse under the medication. Their choices didn’t make much sense — they just kept pulling random items in and out of the backpack. To an observer, they appeared to be focused, well behaved, on task. But in fact, they weren’t accomplishing anything of much value.

Farah directed me to the work of Scott Vrecko, a sociologist who conducted a series of interviews with students at an American university who used stimulant medication without a prescription. He wrote that the students he interviewed would often “frame the functional benefits of stimulants in cognitive-sounding terms.” But when he dug a little deeper, he found that the students tended to talk about their attention struggles, and the benefits they experienced with medication, in emotional terms rather than intellectual ones. Without the pills, they said, they just didn’t feel interested in the assignments they were supposed to be doing. They didn’t feel motivated. It all seemed pointless.

On stimulant medication, those emotions flipped. “You start to feel such a connection to what you’re working on,” one undergraduate told Vrecko. “It’s almost like you fall in love with it.” As another student put it: On Adderall, “you’re interested in what you’re doing, even if it’s boring.”

Socially, though, there was a price. “Around my friends, I’m usually the most social, but when I’m on it, it feels like my spark is kind of gone,” John said. “I laugh a lot less. I can’t think of anything to say. Life is just less fun. It’s not like I’m sad; I’m just not as happy. It flattens things out.”

John also generally doesn’t take his Adderall during the summer. When he’s not in school, he told me, he doesn’t have any A.D.H.D. symptoms at all. “If I don’t have to do any work, then I’m just a completely regular person,” he said. “But once I have to focus on things, then I have to take it, or else I just won’t get any of my stuff done.”

John’s sense that his A.D.H.D. is situational — that he has it in some circumstances but not in others — is a challenge to some of psychiatry’s longstanding assumptions about the condition. After all, diabetes doesn’t go away over summer vacation. But John’s intuition is supported by scientific evidence. Increasingly, research suggests that for many people A.D.H.D. might be thought of as a condition they experience, sometimes temporarily, rather than a disorder that they have in some unchanging way.

For most of his career, he embraced what he now calls the “medical model” of A.D.H.D — the belief that the brains of people with A.D.H.D. are biologically deficient, categorically different from those of typical, healthy individuals. Now, however, Sonuga-Barke is proposing an alternative model, one that largely sidesteps questions of biology. What matters instead, he says, is the distress children feel as they try to make their way in the world.

Sonuga-Barke’s proposed model locates A.D.H.D. symptoms on a continuum, rather than presenting the condition as a distinct, natural category. And it departs from the medical model in another crucial way: It considers those symptoms not as indications of neurological deficits but as signals of a misalignment between a child’s biological makeup and the environment in which they are trying to function. “I’m not saying it’s not biological,” he says. “I’m just saying I don’t think that’s the right target. Rather than trying to treat and resolve the biology, we should be focusing on building environments that improve outcomes and mental health.”

What the researchers noticed was that their subjects weren’t particularly interested in talking about the specifics of their disorder. Instead, they wanted to talk about the context in which they were now living and how that context had affected their symptoms. Subject after subject spontaneously brought up the importance of finding their “niche,” or the right “fit,” in school or in the workplace. As adults, they had more freedom than they did as children to control the parameters of their lives — whether to go to college, what to study, what kind of career to pursue. Many of them had sensibly chosen contexts that were a better match for their personalities than what they experienced in school, and as a result, they reported that their A.D.H.D. symptoms had essentially disappeared. In fact, some of them were questioning whether they had ever had a disorder at all — or if they had just been in the wrong environment as children.

The work environments where the subjects were thriving varied. For some, the appeal of their new jobs was that they were busy and cognitively demanding, requiring constant multitasking. For others, the right context was physical, hands-on labor. For all of them, what made a difference was having work that to them felt “intrinsically interesting.”

“Rather than a static ‘attention deficit’ that appeared under all circumstances,” the M.T.A. researchers wrote, “our subjects described their propensity toward distraction as contextual. … Believing the problem lay in their environments rather than solely in themselves helped individuals allay feelings of inadequacy: Characterizing A.D.H.D. as a personality trait rather than a disorder, they saw themselves as different rather than defective.”

For the young adults in the “niche” study who were interviewed about their work lives, the transition that helped them overcome their A.D.H.D. symptoms often was leaving academic work for something more kinetic. For Sonuga-Barke, it was the opposite. At university, he would show up at the library at 9 every morning and sit in his carrel working until 5. The next day, he would do it again. Growing up, he says, he had a natural tendency to “hyperfocus,” and back at school in Derby, that tendency looked to his teachers like daydreaming. At university, it became his secret weapon

I asked Sonuga-Barke what he might have gained if he grew up in a different time and place — if he was prescribed Ritalin or Adderall at age 8 instead of just being packed off to the remedial class. “I don’t think I would have gained anything,” he said. “I think without medication, you learn alternative ways of dealing with stuff. In my particular case, there are a lot of characteristics that have helped me. My mind is constantly churning away, thinking of things. I never relax. The way I motivate myself is to turn everything into a problem and to try and solve the problem.”

“The simple model has always been, basically, ‘A.D.H.D. plus medication equals no A.D.H.D.,’” he says. “But that’s not true. Medication is not a silver bullet. It never will be.” What medication can sometimes do, he believes, is allow families more room to communicate. “At its best,” he says, “medication can provide a window for parents to engage with their kids,” by moderating children’s behavior, at least temporarily, so that family life can become more than just endless fights about overdue homework and lost lunchboxes. “If you have a more positive relationship with your child, they’re going to have a better outcome. Not for their A.D.H.D. — it’s probably going to be just the same. But in terms of dealing with the self-hatred and low self-esteem that often goes along with A.D.H.D.

The alternative model, by contrast, tells a child a very different story: that his A.D.H.D. symptoms exist on a continuum, one on which we all find ourselves; that he may be experiencing those symptoms as much because of where he is as because of who he is; and that next year, if things change in his surroundings, those symptoms might change as well. Armed with that understanding, he and his family can decide whether medication makes sense — whether for him, the benefits are likely to outweigh the drawbacks. At the same time, they can consider whether there are changes in his situation, at school or at home, that might help alleviate his symptoms.

Admittedly, that version of A.D.H.D. has certain drawbacks. It denies parents the clear, definitive explanation for their children’s problems that can come as such a relief, especially after months or years of frustration and uncertainty. It often requires a lot of flexibility and experimentation on the part of patients, families and doctors. But it has two important advantages as well: First, the new model more accurately reflects the latest scientific understanding of A.D.H.D. And second, it gives children a vision of their future in which things might actually improve — not because their brains are chemically refashioned in a way that makes them better able to fit into the world, but because they find a way to make the world fit better around their complicated and distinctive brains.

You know what you should be doing. You know the steps you should be taking, the little actions that will pave the way forward. You know you’re perfectly capable of taking those steps, that there’s no good reason to delay any longer, and yet… 🌞 a weekly newsletter for conscious self-creation 🪴 join 600+ subscribers: Subscribe What do you do instead? You scroll Twitter. You stare at the ceiling. You clean your apartment (again). You dilly dally. You do a bunch of things that you don’t even really like doing, and then you feel even worse.

The result is a vicious spiral downwards, where we keep doing things that drain us of energy, and then we don’t have the energy to do the things we actually want to do, and so we do more of the things which are depleting, and… well, so on, so on. Where we actually want to create is the opposite: a virtuous spiral upwards, where we focus on things which inspire us, giving us energy to take on bigger and bigger challenges, unlocking even more energy

The first thing to notice is that the things that deplete us have gravity. We don’t choose them freely. They pull us into old patterns, often without us noticing. That gravity is a product of fear. Your nervous system has one primary goal: keep you alive. It has one primary method of doing so: keep doing the things that kept you alive before. Our biology has an incredible bias towards the familiar, because familiar = safe. When our body is experiencing fear, that means our nervous system thinks we’re in danger. The fear says “get somewhere safe, now.” That translates to “get back to the familiar.”

Which means… if we’re able to be present and curious with the tension in our body, without trying to fight it or “fix” it or “solve” it, our experience transforms. Suddenly, the tension becomes almost pleasurable, as an opportunity to “be with” ourselves. This process does take a bit of practice, but once you’ve found it, you’ll know. It’s the deeply satisfying sense of “I am stepping into fear, but I am not alone—I have my own back.” 🌞 a weekly newsletter for conscious self-creation 🪴 join 600+ subscribers: Subscribe Once we’ve unlocked that feeling, then it becomes easier and easier to break out of these draining patterns. Attunement-to-self is an energizing process, so the moment we begin noticing what we’re feeling, we’re stepping away from depletion. We’ve instantly liberated ourselves from stuckness.

My problems were too complex and modern to explain. So I skated across parking lots, breezeways, and sidewalks, I listened to the vibration of my wheels on brick, I learned the names of flowers, I put deserted paths to use. I decided for myself each curve I took, and by the time I rolled home, I felt lighter. One Saturday, a friend invited me to roller-skate in the park. I can still picture her in green protective knee pads, flying past. I couldn’t catch up, I had no technique. There existed another scale to evaluate roller skating, beyond joy, and as Rollerbladers and cyclists overtook me, it eclipsed my own. Soon after, I stopped skating.

the end point for the working artist is to create an object for sale. Once the art object enters the market, art’s intrinsic value is emptied out, compacted by the market’s logic of ranking, until there’s only relational worth, no interior worth. Two novelists I know publish essays one week apart; in a grim coincidence, each writer recounts their own version of the same traumatic life event. Which essay is better, a friend asks. I explain they’re different; different life circumstances likely shaped separate approaches. Yes, she says, but which one is better?

we are inundated with cold, beautiful stats, some publicized by trade publications or broadcast by authors themselves on all socials. How many publishers bid? How big is the print run? How many stops on the tour? How many reviews on Goodreads? How many mentions on Bookstagram, BookTok? How many bloggers on the blog tour? How exponential is the growth in follower count? Preorders? How many printings? How many languages in translation? How many views on the unboxing? How many mentions on most-anticipated lists?

A starred review from Publisher’s Weekly, but I wasn’t in “Picks of the Week.” A mention from Entertainment Weekly, but last on a click-through list.

There must exist professions that are free from capture, but I’m hard pressed to find them. Even non-remote jobs, where work cannot pursue the worker home, are dogged by digital tracking: a farmer says Instagram Story views directly correlate to farm subscriptions, a server tells me her manager won’t give her the Saturday-night money shift until she has more followers.

What we hardly talk about is how we’ve reorganized not just industrial activity but any activity to be capturable by computer, a radical expansion of what can be mined. Friendship is ground zero for the metrics of the inner world, the first unquantifiable shorn into data points: Friendster testimonials, the MySpace Top 8, friending. Likewise, the search for romance has been refigured by dating apps that sell paid-for rankings and paid access to “quality” matches. Or, if there’s an off-duty pursuit you love—giving tarot readings, polishing beach rocks—it’s a great compliment to say: “You should do that for money.” Join the passion economy, give the market final say on the value of your delights. Even engaging with art—say, encountering some uncanny reflection of yourself in a novel, or having a transformative epiphany from listening, on repeat, to the way that singer’s voice breaks over the bridge—can be spat out as a figure, on Goodreads or your Spotify year in review.

And those ascetics who disavow all socials? They are still caught in the network. Acts of pure leisure—photographing a sidewalk cat with a camera app or watching a video on how to make a curry—are transmuted into data to grade how well the app or the creators’ deliverables are delivering. If we’re not being tallied, we affect the tally of others. We are all data workers.

In a nightmarish dispatch in Esquire on how hard it is for authors to find readers, Kate Dwyer argues that all authors must function like influencers now, which means a fire sale on your “private” life. As internet theorist Kyle Chayka puts it to Dwyer: “Influencers get attention by exposing parts of their life that have nothing to do with the production of culture.”

what happens to artists is happening to all of us. As data collection technology hollows out our inner worlds, all of us experience the working artist’s plight: our lot is to numericize and monetize the most private and personal parts of our experience.

We are not giving away our value, as a puritanical grandparent might scold; we are giving away our facility to value. We’ve been cored like apples, a dependency created, hooked on the public internet to tell us the worth.

When we scroll, what are we looking for?

While other fast fashion brands wait for high-end houses to produce designs they can replicate cheaply, Shein has completely eclipsed the runway, using AI to trawl social media for cues on what to produce next. Shein’s site operates like a casino game, using “dark patterns”—a countdown clock puts a timer on an offer, pop-ups say there’s only one item left in stock, and the scroll of outfits never ends—so you buy now, ask if you want it later. Shein’s model is dystopic: countless reports detail how it puts its workers in obscene poverty in order to sell a reprieve to consumers who are also moneyless—a saturated plush world lasting as long as the seams in one of their dresses. Yet the day to day of Shein’s target shopper is so bleak, we strain our moral character to cosplay a life of plenty.

(Unsplash) Technology The Collapse of Self-Worth in the Digital Age Why are we letting algorithms rewrite the rules of art, work, and life? BY THEA LIM Updated 17:52, Sep. 20, 2024 | Published 6:30, Sep. 17, 2024 W HEN I WAS TWELVE, I used to roller-skate in circles for hours. I was at another new school, the odd man out, bullied by my desk mate. My problems were too complex and modern to explain. So I skated across parking lots, breezeways, and sidewalks, I listened to the vibration of my wheels on brick, I learned the names of flowers, I put deserted paths to use. I decided for myself each curve I took, and by the time I rolled home, I felt lighter. One Saturday, a friend invited me to roller-skate in the park. I can still picture her in green protective knee pads, flying past. I couldn’t catch up, I had no technique. There existed another scale to evaluate roller skating, beyond joy, and as Rollerbladers and cyclists overtook me, it eclipsed my own. Soon after, I stopped skating. Y EARS AGO, I worked in the backroom of a Tower Records. Every few hours, my face-pierced, gunk-haired co-workers would line up by my workstation, waiting to clock in or out. When we typed in our staff number at 8:59 p.m., we were off time, returned to ourselves, free like smoke. There are no words to describe the opposite sensations of being at-our-job and being not-at-our-job even if we know the feeling of crossing that threshold by heart. But the most essential quality that makes a job a job is that when we are at work, we surrender the power to decide the worth of what we do. At-job is where our labour is appraised by an external meter: the market. At-job, our labour is never a means to itself but a means to money; its value can be expressed only as a number—relative, fluctuating, out of our control. At-job, because an outside eye measures us, the workplace is a place of surveillance. It’s painful to have your sense of worth extracted. For Marx, the poet of economics, when a person’s innate value is replaced with exchange value, it is as if we’ve been reduced to “a mere jelly.” Wait—Is ChatGPT Even Legal? AI Is a False God How Israel Is Using AI as a Weapon of War Not-job, or whatever name you prefer—“quitting time,” “off duty,” “downtime”—is where we restore ourselves from a mere jelly, precisely by using our internal meter to determine the criteria for success or failure. Find the best route home—not the one that optimizes cost per minute but the one that offers time enough to hear an album from start to finish. Plant a window garden, and if the plants are half dead, try again. My brother-in-law found a toy loom in his neighbour’s garbage, and nightly he weaves tiny technicolour rugs. We do these activities for the sake of doing them, and their value can’t be arrived at through an outside, top-down measure. It would be nonsensical to treat them as comparable and rank them from one to five. We can assess them only by privately and carefully attending to what they contain and, on our own, concluding their merit. And so artmaking—the cultural industries—occupies the middle of an uneasy Venn diagram. First, the value of an artwork is internal—how well does it fulfill the vision that inspired it? Second, a piece of art is its own end. Third, a piece of art is, by definition, rare, one of a kind, nonfungible. Yet the end point for the working artist is to create an object for sale. Once the art object enters the market, art’s intrinsic value is emptied out, compacted by the market’s logic of ranking, until there’s only relational worth, no interior worth. Two novelists I know publish essays one week apart; in a grim coincidence, each writer recounts their own version of the same traumatic life event. Which essay is better, a friend asks. I explain they’re different; different life circumstances likely shaped separate approaches. Yes, she says, but which one is better? I GREW UP a Catholic, a faithful, an anachronism to my friends. I carried my faith until my twenties, when it finally broke. Once I couldn’t gain comfort from religion anymore, I got it from writing. Sitting and building stories, side by side with millions of other storytellers who have endeavoured since the dawn of existence to forge meaning even as reality proves endlessly senseless, is the nearest thing to what it felt like back when I was a believer. I spent my thirties writing a novel and paying the bills as low-paid part-time faculty at three different colleges. I could’ve studied law or learned to code. Instead, I manufactured sentences. Looking back, it baffles me that I had the wherewithal to commit to a project with no guaranteed financial value, as if I was under an enchantment. Working on that novel was like visiting a little town every day for four years, a place so dear and sweet. Then I sold it. As the publication date advanced, I was awash with extrinsic measures. Only twenty years ago, there was no public, complete data on book sales. U

I spent so many years of my life trying to live mostly in my head. Intellectualizing everything made me feel like it was manageable. I was always trying to manage my own reactions and the reactions of everyone else around me. Learning how to manage people was the skill that I had been lavishly rewarded for in my childhood and teens. Growing up, you’re being reprimanded in a million different ways all the time, and I learned to modify my behavior so that over time I got more and more positive feedback. People like it when you do X and not Y, say X and not Y. I kept track of all of it in my head and not in my body. Intellectualizing kept me numbed out, and for a long time what I wanted was nothing more than to be numbed out, because when things hurt they hurt less. Whatever I felt like I couldn’t show people or tell people I hid away. I compartmentalized, and what I put in the compartment I never looked at became my shadow.

So much of what I care about can be boiled down to this: when you’re able to really inhabit and pay attention to your body, it becomes obvious what you want and don’t want, and the path towards your desires is clear. If you’re not in your body, you constantly rationalizing what you should do next, and that can leave you inert or trapped or simply choosing the wrong thing over and over. "I know I should, but I can’t do it” is often another way of saying “I’ve reached this conclusion intellectually, but I’m so frozen out of my body I can’t feel a deeper certainty.”

It was so incredibly hard when people gave me negative feedback—withdrew, or rejected me, or were just preoccupied with their own problems—because I relied on other people to figure out whether everything was alright.

When I started living in my body I started feeling for the first time that I could trust myself in a way that extended beyond trust of my intelligence, of my ability to pick up on cues in my external environment.

I can keep my attention outwards, I don’t direct it inwards in a self-conscious way. It’s the difference between noticing whether someone seems to having a good time in the moment by watching their face vs agonizing about whether they enjoyed something after the fact. I can tell the difference between when I’m tired because I didn’t sleep well versus tired because I’m bored versus tired because I’m avoiding something. When I’m in my body, I’m aware of myself instead of obsessing over my state, and this allows me to have more room for other people.

Before explaining “3 Ways Past Trauma Can Show Up in Your Present” or “5 Signs of a Highly Sensitive Person,” Dr. Julie will use a visual hook — she’ll pour out a bucket of candy, flip over a giant hourglass, or pose next to a tantalizingly tall stack of dominos (like any skilled content creator, she knows not to give us the final knockdown until at least halfway through) to keep you watching. Does it matter that “high-functioning depression” and “highly sensitive person” aren’t actual diagnoses? Maybe. Or maybe not.

While most full-time therapists whose rates are set by insurance companies max out at around $100,000 per year, therapists who are full- or part-time content creators can make much, much more. @TherapyJeff, real name Jeff Guenther, an individual and couples therapist in Portland, Oregon, says he can make eight or nine times that amount on social media in the form of brand deals, merch, and direct subscriptions. When I clarify whether he’s making nearly a million dollars, he says, “It’s been an especially good year.”

What works on the app is simple, visually arresting videos that make you feel like they landed in your lap with a kind of cosmic destiny (the comments on these videos often repeat some version of “my For You page really said ‘FOR YOU.’”)

Therapists do cute little dances next to cute little graphics about what it’s like to have both ADHD and PMDD; they’ll lip sync to trending songs in videos about how to spot a depressed client who might have made a suicide plan; they’ll hop onto memes as a way to criticize parents who haven’t gone to therapy.

The most successful TikTok counselors don’t typically advertise their one-on-one therapy services; instead, they’ll sell products that establish themselves as mental-health experts but have the potential to net influencer-size salaries.

“I have been accused of being a toxic validator,” he admits. “Like, imagine that your ex-boyfriend is watching my content. Somebody might be coming across, like, a piece of my content that they can use in order to feel better about themselves, even when they should probably actually be doing some work and taking accountability.” But ultimately, who TikTok shows his videos to isn’t in his control.

Even if viewers know watching therapy content isn’t the same thing as actually going to therapy, when a professional therapist comes up on your feed to tell you exactly what you most want to hear at a time when you’re most in need of hearing it — that you are good, that you will be okay, and also here’s a cute little visual hook — you’ll keep watching.

I was so used to hearing from teachers and family that if I just didn’t procrastinate and worked all the time, I could do anything! I had all this potential I wasn’t living up to! And that’s true, as far as it goes, but that’s like saying if Usain Bolt just kept going he could be the fastest marathon runner in the world. Why does he stop at the end of the race??

Now, I’ve found that I do need to work on not procrastinating. Not because the product is better, even, but because it’s better for my mental health and physical health to not have a full, sweating, panicked breakdown over every task even if the task itself turns out excellently. It’s a shitty way to live! You feel bad ALL the time! And I don’t deserve to live like that anymore.

I don’t have an ocean of productivity and accomplishments inside of me that I could easily, effortlessly access if I just sat down 8 hours a day and worked. There’s no fucking way. That’s not real. It’s an illusion. It’s fine not to live up to an illusion.

I think a lot of folks feel like you should be doing these certain things like writing the great American novel or reading the 100 Greatest Movies of All-Time when in actuality these are achievements that have no real guarantee of happiness. Unless you are truly enjoying those journeys, there is no reason to set upon them.

I don't think there is anything wrong with having hopes and dreams, but I do feel that maybe we allow those things to be excuses for not living a content life. I also think at times we hold onto old dreams that no longer serve us, instead of focusing on something new and more applicable to your current situation.

adulthood wasn't full of Ferraris and mansions, and I found out rather quickly that I wasn't going to save anyone, because I was struggling to save myself.

Rumination is a form of perserverative cognition that focuses on negative content, generally past and present, and results in emotional distress. Initial studies of rumination emerged in the psychological literature, particularly with regard to studies examining specific facets of rumination (e.g., positive vs. negative rumination, brooding vs. self-reflection, relationships with catastrophic thinking, role of impaired disengagement, state vs. trait features) as well as the presence of rumination in various psychiatric syndromes (e.g., depression, alcohol misuse, generalized anxiety disorder, social anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder, bulimia nervosa).

Your emotions are a signaling mechanism. They are your subconscious mind’s toolkit for protecting you from dangers, improving your circumstances, and navigating an otherwise incomprehensibly complex world. Every emotion has some adaptive purpose: fear keeps you safe; anger enforces your boundaries; sadness slows you down; joy speeds you up.

The first step towards living better is to recognize that your subconscious mind is trying to tell you things you don’t yet know (primarily through your emotions, but also via other channels like your dreams). A lot of people struggle to realize even this basic fact; they think of emotions as a disruption: a distraction from, say, their career development, or an impediment to their capacity to “be rational.”

your emotions are worth heeding because they carry wisdom your conscious mind doesn’t have access to. And at that point you must embark on the second step—the much harder step—of figuring out what it is that your mind is trying to tell you.

an attitude of curiosity rather than doubt. Embodiment rather than intellect. You find the answer by allowing yourself to be playful, generative, and spontaneous; not by being methodical, intentional, and constricted. Sit back and feel your way to the answer

The perceived ‘self’ is an amalgamation shaped by quasi-independent personalities influenced by genetics, upbringing, memories, and trauma. Much of our behavior is driven by animalistic passions and irrepressible emotions.And I think that’s what we hate: We hate not being the boss of our own heads. We hate not being in control. The puppet wishes to overpower the strings—parts of her own body—that keep her upright and sensible.

Girard told us that imitation is the texture of the human experience, that we are constantly orchestrated by desires, and that we are fluid beings who are always becoming more like who we look up to. So, in this light, trying to become the best version of yourself creates an impossible loop: You need the best version of yourself to exist so you know what to strive for in order to become it, but the best version of you can not exist if you do not become it first. Chicken and egg.

the marionette can not be its own puppeteer; that would be a paradox. Trying to improve the self is like Narcissus staring at his reflection: Neither you nor your reflection—who you want to be—changes. You can not improve yourself by staring back at yourself in the same way that a mirror can not become a portrait.1 Self-deficiency implies that external help is needed. You are imperfect at best. You can not produce something from nothing, multiply without a multiplier, or draw straight with crooked lines.

Instead of self-fulfillment or self-actualization, perhaps we are meant to self-deny so we can make room for a Savior. The reason is in its name: Christ-ian, meaning Christ-like, suggests that we shouldn’t be imitating or striving to be some imaginative best-version-of-myself, but rather, someone completely external and objectively Good to the perfect degree.

I'm not sure I agree with *everything* you wrote above, but as I've gotten older, I find myself turning less to self-help books, articles, etc., and more to just hanging out with friends and family.

I have come to see funks as an entirely internal phenomenon: a persistent psychological block that gets darker and denser each moment you stay in it.

From Swami Vivekananda’s “Inspired Talks”:“We are what our thoughts have made us; so take care of what you think. Words are secondary. Thoughts live, they travel far. Each thought is [like] a little hammer blow on the lump of iron which our bodies are, manufacturing out of it what we want to be.”

“Woke” vs. “Anti-woke” is a horribly exhausted and pointless framework, one which suggests binary simplicity where there is only boundless complexity, but beyond that, there was never any chance that there was going to be some clear victory for one or the other. What will emerge will be some synthesis of the two impulses.

I think there's gathering dissatisfaction with a common set of tropes regarding personal agency and mental health. In particular, I think that the dominance of the therapeutic assumption in American life, and the role of affirmation within it, will be challenged. Currently, an inescapable American cultural mode, particularly among the educated, is one of mandatory therapeutic maximalism and an attendant tyranny of affirmation.

Of course I want us to present people with alternative ways to feel about themselves and their mental health, but it can’t become just another catechism, a different checklist. There’s got to be an understanding that the human tools for confronting life are limited and contextual, some of them come from art and not from therapy, and that ultimately we’re all left to blunder along on our own paths, trying to achieve stability and self-ownership - but we’re not guaranteed to get either. So I would hope that this counter-movement would remain a matter of skeptical inquiry and not just another set of gurus.

Not getting what you want is a default and healthy status, not a tragedy, though you are perfectly within your rights to be unhappy about it, and people who do not give you everything you want are not inherently “toxic,” though you’re perfectly within your rights to be unhappy with them

Sick people have as much responsibility to manage their disorders as society has to give them the tools to manage them; you cannot ask others to give you accommodation for your disability if you refuse to take accountability for it yourself

If you want to be good to yourself, I suggest that you stop expecting society to be your therapist and go see licensed medical professionals in private to address the issues in your life that are appropriately treated that way. And if you want to be good to your society, I suggest you help to defeat the medicalization of everything, the casualization of the concept of trauma, the celebration of mental disorders, the assumption that everything that makes us unhappy is an injustice, the insistence that all conflict is abuse, and the infantilization of the human animal

Sometimes you don’t have ADHD, you just hate your job. Sometimes your boss isn’t a sociopath, he’s just correctly identified you as unqualified for a leadership position. Sometimes you really do have schizophrenia, only there’s nothing glamorous or exciting or romantic about it, and now you’re fat from meds and trying to hold down a steady job and going to support group to drink grainy coffee and hear people tell the same stories over and over again. And sometimes you’re just in pain because the world didn’t turn out the way you wanted it to, and you’re trying to scratch out a life you can live with, and you get overwhelmed with your mundane unhappiness on the subway home from work, and you think to yourself that it must be true that your suffering is something grander, something that calls out for medical attention and reasonable accommodation, something more that makes it easier.

I think there are a million things to be discouraged about in the world, but I do think that the progress being made on "what it means to be a man" is moving in the right direction. It's clear men can be terrible, and the last decade in particular has had several movements root out some of the worst offenders, but I truly think all of us no matter our gender are more alike than we've historically thought, and the more we recognize that the better off we'll be.

A growing number of initiatives across Europe are using access to the arts as a tool to improve health and well-being alongside classic medical treatment. In the Danish town of Silkeborg, a group of new mothers who suffered from postpartum depression reported feeling closer to their newborns, calmer and more optimistic after taking part in weekly singing sessions designed to improve their mental health.Similar results were also observed in groups also participating in the World Health Organisation's (WHO) Music for Motherhood project in four other cities in Italy and Romania. "Just like being physically active has health benefits, being culturally active also has health benefits," Nils Fietje, Technical Officer at the World Health Organisation and co-director of its Arts and Health Lab, told Euronews.

“Arts and culture are important in promoting the positive mental health and well-being of individuals and society in general by supporting social inclusion and reducing mental health stigma.”

Where does the line fall between the parental responsibility for loving and caring for a child that you've forced into existence, and your own personal responsibility for growing as a person? I wish I knew.

In dozens of interviews with families I heard about doctors shaming low-income moms for buying dollar store ramen noodles instead of pricier fresh vegetables. I talked to teenagers who were gaining weight while dealing with depression or anxiety and whose doctors told them to cut carbs. Families described doctors who rushed conversations, grabbed bellies or made jokes about kids’ bodies.

What should the obesity guidelines say instead? Stop classifying kids and their health by body size altogether. This would involve a paradigm shift to weight-inclusive approaches, which see weight change as a possible symptom of, or a contributing factor toward, a larger health concern or struggle. These approaches focus providers on addressing that issue rather than managing weight loss. This means looking less at the number on the scale and talking more to families about their health priorities and challenges. Can they add healthy foods rather than restrict calories?

We cannot solve anti-fat bias by making fat kids thin. Our current approach only teaches them that trusted adults believe the bullies are right — that a fat body is just a problem to solve. That’s not where the conversation about anyone’s health should begin.

those most likely to become entrepreneurs are well-rounded. A 2005 study from Edward Lazear suggests that the self-employed tend to be generalists, not specialists.

Unlike the “trauma plot,” Parul Sehgal’s coinage for the use of trauma as narrative payoff, the therapeutic plot doesn’t wallow in trauma itself. Instead, it offers formulaic accounts of diagnosis and healing—what Janet Malcolm has called “the streamlined truisms of the age of mental health.”

Book blogs sort recommendations by pathology (severe social anxiety, schizophrenia, body dysmorphia), symptom (anxiety, panic attacks), and trauma (parental suicide, psychiatric stay). Fans diagnose characters with mental disorders (a fan theory diagnoses the character Bruno from another recent Pixar offering, Encanto, with obsessive compulsive disorder). Self-diagnosis even informed the development of Everything Everywhere. In early drafts of the script, Evelyn suffered from undiagnosed attention deficit hyperactivity disorder. Writing and researching her character inspired Kwan to identify and seek treatment for his own heretofore undiagnosed ADHD.

No doubt, such a medical diagnosis can provide relief and resolution. But is such a diagnosis the job of art? What is lost when audiences and creators eschew other ways of discussing fiction (for example, E.M. Forster’s distinction between round and flat characters) and instead reduce characters to clinical profiles?

In ancient Athenian tragedy, catharsis was defined by Aristotle’s Poetics as the ritual purification and purgation of emotions, particularly pity and fear. Pity arises from identification with the tragic hero, whose nobility is compromised by a fatal flaw, and fear is elicited by his excessive punishment. The therapeutic significance of catharsis originated much later in the theories of Sigmund Freud. By applying Joseph Breuer’s “cathartic method,” Freud theorized that hypnosis allowed patients to recall the traumatic experience at the root of their condition. Catharsis was Freud’s first major breakthrough, and his first brush with the powers of the unconscious that would form the underpinnings of psychoanalytic theory.For Aristotle, catharsis was the result of anagnorisis—the humility produced by the tragic hero’s recognition not only of the calamity that had befallen him, but also of his own role in bringing it about. Freud, meanwhile, described an inherent tragedy in the “impossible profession” of psychoanalysis, “in which one can be sure beforehand of achieving unsatisfying results.” It wasn’t that Freud had no faith in his own methods; he simply perceived the enormity of the human condition, and understood that the odds of success were not stacked in the psychoanalyst’s favor.Humility is absent from today’s therapeutic catharsis, which assumes with algorithmic certainty that sharing will lead to understanding, and that understanding will lead to healing. Art’s role, according to Everything Everywhere actress Stephanie Hsu, is “to hold space for trauma and offer catharsis,” and to recognize that “empathy and radical empathy and radical kindness are also a tool.” Buried beneath this gauzy language is the fact that the “empathy” of Turning Red and Everything Everywhere rely on the transformation of the mothers, not their children. The adults must learn that children are individuals rather than extensions of parental will, and when empathy is granted to mothers, it is only through their shared status as victims.

Pity the immigrant women who fled war-torn nations and corrupt regimes only to be subjected to psychoanalysis from hipster filmmakers and their own children

All this is not to say that storytelling holds no empathic power, nor an ability to transcend individual perspectives. But this power lies in art’s ability to overthrow, not reify, easy solutions—to challenge rather than “validate.” The transmission of suffering from one generation to the next is a worthy subject for art, but not because its effect on any particular demographic has been under-represented.

Our approach to culture should account for rigor and complexity, not defer to trite solutionism.

I’ve always been a pretty goal-oriented person — but mostly because I frame my goals on a salvation scale. It’s not enough for achieving a thing to offer me exactly what I want — my brain craves anything I aim for to hold the key to everything that I need. As diabolical as this sounds, it’s extremely effective. With stakes that high, I’m willing to pull out all the stops. Failure just doesn’t feel like an option. By telling myself that whatever I’m reaching for will essentially allow me to achieve nirvana, I guarantee that motivation will never be in short supply.

But with that comes the feeling that anything but progressing through life at warp speed is probably proof that you’re doing something deeply wrong.

In my case, I want things to feel hard. How else will I know that I’m making progress? In practice, this sentiment easily leads to self-sabotage. It encourages me to pick projects and people that give my overactive brain a silly sudoku-like game to play while matching my mind’s stock image of “meaningfulness.”

Your brain might be able to whip up a five-page single-spaced essay outlining exactly what you want and need in extensive detail, but your heart will always have the last word (and trust me, they will fit on a post-it).

We seem to be afraid brevity might make us look unintelligent or uninformed. Over-intellectualizing our decisions to signal we understand the complexity of the world is now the new norm.

it’s a good sign when things feel remarkably simple and wordlessly right. And when they do, it’s interesting to look around and notice how incredibly irrelevant speed is.

Autism has been gentrified. This is a dynamic I now cannot stop seeing: once a human attribute like autism or mental illness becomes seen as an identity marker that is useful for social positioning among the chattering class, the conversation about that attribute inevitably becomes fixated on those among that chattering class. It becomes impossible to escape their immense social gravity. The culture of that attribute becomes distorted and bent towards the interests and biases of those who enjoy the privilege of holding society’s microphone.

Today we have the usual demand to have it both ways, to be seen as one’s disorder when convenient for differentiating ourselves from the pack and then setting aside that definition when uncomfortable. Again, the truly disabled can’t do this. They do not deftly craft facades from their disorders, lacking the self-control and capacity for social scheming required to do so. They aren’t afforded the possibility of ignoring their condition when convenient. Yet the voice of the ambitious and shameless patient seeking validation and coin for being sick is becoming the voice of mental illness, those unprincipled enough to treat it all as marketing. Mental illness should not be fodder for building your personal brand.

there is something disordered, and untoward, about a society in which legions of successful people have suddenly discovered their diagnoses and, despite those conditions never having impeded their relentless marches up the ladder of American meritocracy, making the mental illness conversation all about them.

how do you proceed with your quest to turn mental illness into a positive thing, an honored thing, a “valid” thing, without inevitably privileging the narratives and interests of those whose mental illness is least malign? How do you tell generations of young strivers that having a mental illness is cool and unique, without alienating those who feel neither cool nor unique, but only afflicted?

How do you keep the schizophrenic and the schizoaffective and the bipolar and the borderline and the violent and the self-harming and the catatonic and the permanently deluded at the forefront of the culture? Because the way things are going, contemporary mental illness discourse threatens to do to the truly incapacitated the very thing it claims to oppose - leaving them voiceless, ignored, unheard, alone.

the police are at wits’ end. It all speaks to the desperate need for a statewide mental health system, funded with help from the feds. The problem is just too big for San Francisco to solve on its own.