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Put an end to contemplating the end.


There are at least ten disorders or conditions that may include suicidal thinking and behavior. If you have experienced that, focus first on getting out of the crisis. Next, figure out where the thoughts, obsessions, impulses, are coming from. Try to figure out the cause so that you can get the best, most targeted treatment. Not every suicidal thought comes from depression. So treatment for depression may not treat your bad thoughts. You may survive the crisis only to return to work and find yourself going downhill again into those sorts of thoughts.

Now, while you are not in crisis, is the time to figure out the source of the problem in order that you can get access to the most targeted treatment.

I asked ChatGPT which disorders and conditions may include symptoms similar to suicidal thinking, suicidal ideation, suicidal impulses, urges, compulsions, obsessions and intrusive thoughts?


Several mental health disorders and conditions may include symptoms that involve suicidal thinking, ideation, impulses, urges, compulsions, obsessions, and intrusive thoughts. It’s important to note that experiencing these symptoms does not necessarily mean a person will act on them, but it’s crucial to take such thoughts seriously and seek professional help. Some of the disorders and conditions associated with these symptoms include:

  1. Depression:
    • Symptoms: Persistent feelings of sadness, hopelessness, worthlessness, and a lack of interest or pleasure in activities. Suicidal ideation and thoughts of death may be present.
  2. Bipolar Disorder:
    • Symptoms: Periods of intense mood swings, including depressive episodes with suicidal thoughts and manic or hypomanic episodes with impulsive behaviors.
  3. Borderline Personality Disorder (BPD):
    • Symptoms: Intense and unstable relationships, identity disturbances, emotional dysregulation, and impulsivity. Individuals with BPD may be at an increased risk of suicidal behavior.
  4. Schizophrenia:
    • Symptoms: Psychotic symptoms, such as hallucinations and delusions, can sometimes lead to severe distress and suicidal thoughts. Individuals with schizophrenia may also experience depressive symptoms.
  5. Post-Traumatic Stress Disorder (PTSD):
    • Symptoms: Individuals who have experienced trauma may struggle with intrusive thoughts, nightmares, and flashbacks, which can contribute to feelings of despair and hopelessness.
  6. Obsessive-Compulsive Disorder (OCD):
    • Symptoms: Intrusive thoughts, known as obsessions, may include themes of self-harm or suicidal thinking. Compulsions may involve rituals to prevent harm.
  7. Eating Disorders (e.g., Anorexia Nervosa, Bulimia Nervosa):
    • Symptoms: Individuals with eating disorders may experience intense preoccupation with body image, weight, and food. Suicidal thoughts may be associated with feelings of guilt, shame, and despair.
  8. Substance Use Disorders:
    • Symptoms: Substance abuse can contribute to or exacerbate mental health conditions. Individuals may turn to substances as a way to cope with emotional pain and distress, increasing the risk of suicidal thoughts.
  9. Major Life Transitions or Loss:
    • Transitions or losses, such as the death of a loved one, divorce, or job loss, can lead to intense emotional distress and an increased risk of suicidal thoughts.
  10. Chronic Pain or Illness:
    • Individuals dealing with chronic pain or a severe illness may experience persistent emotional distress and thoughts of ending their suffering.

It’s crucial to recognize that suicidal thoughts are serious and require prompt attention from mental health professionals. If you or someone you know is experiencing such thoughts, it is important to seek help immediately. Reach out to a mental health provider, contact a helpline, or go to the nearest emergency room. Many countries have suicide prevention hotlines and crisis intervention services available 24/7. Remember that help is available, and it’s important to reach out for support.


Treating agoraphobia with CBT and ERP


How would CBT and ERP treat agoraphobia?
What is agoraphobia?

Agoraphobia is a type of anxiety disorder characterized by an intense fear and avoidance of situations or places where escape might be difficult, embarrassing, or help might not be readily available in the event of a panic attack or other incapacitating symptoms. People with agoraphobia often experience significant anxiety about being in places or situations from which escape might be challenging or where help might be unavailable.<

Common situations that may trigger agoraphobia include:

  1. Crowded places: Such as shopping malls, public transportation, or theaters.
  2. Open spaces: Like parking lots or bridges.
  3. Enclosed spaces: Such as elevators or small rooms.
  4. Using public transportation: Like buses, trains, or airplanes.
  5. Being outside of the home alone: Without a trusted companion.

Agoraphobia often develops as a complication of panic disorder, where individuals experience recurrent and unexpected panic attacks. The fear of having a panic attack in public or in a situation where escape is difficult becomes a central feature of agoraphobia.

Key features of agoraphobia include:

  1. Avoidance Behavior: Individuals with agoraphobia often go to great lengths to avoid situations they fear may trigger anxiety or panic attacks. This can significantly limit their daily activities and impact their quality of life.
  2. Anxiety or Panic Attacks: The fear of having a panic attack is a central component of agoraphobia. Individuals may worry about the physical sensations associated with anxiety and panic, such as rapid heartbeat, shortness of breath, dizziness, or a sense of losing control.
  3. Dependency on Others: Some individuals with agoraphobia may become dependent on others for support and reassurance. They may avoid going out alone and prefer to be accompanied by a trusted person.
  4. Physical Symptoms: Anxiety and avoidance behaviors may be accompanied by various physical symptoms, including muscle tension, sweating, trembling, nausea, and a sense of impending doom.

It’s important to note that agoraphobia can vary in severity, and the impact on an individual’s life can range from mild to severe. The condition can be debilitating and significantly affect a person’s ability to engage in normal daily activities.

Treatment for agoraphobia often involves psychotherapy, such as cognitive-behavioral therapy (CBT) and exposure therapy (specifically, Exposure and Response Prevention or ERP). Medications, particularly selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines, may also be considered in some cases. Seeking professional help from a mental health provider is crucial for accurate diagnosis and effective treatment planning

Per ChatGPT

Cognitive-Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) are two therapeutic approaches commonly used in the treatment of agoraphobia. These approaches can be used separately or in combination, depending on the individual’s needs and preferences. Here’s how CBT and ERP may be applied to treat agoraphobia:

Cognitive-Behavioral Therapy (CBT):

  1. Cognitive Restructuring:
    • Goal: Identify and challenge negative thought patterns related to agoraphobia.
    • Process: The individual works with the therapist to recognize and reframe irrational or distorted thoughts that contribute to anxiety. This may involve challenging catastrophic thinking or addressing unrealistic fears.
  2. Education and Psychoeducation:
    • Goal: Provide information about agoraphobia and anxiety.
    • Process: The therapist educates the individual about the nature of agoraphobia, its triggers, and the role of anxiety. Psychoeducation helps the individual understand the connection between thoughts, emotions, and behaviors.
  3. Skills Training:
    • Goal: Develop coping skills and strategies.
    • Process: The individual learns and practices coping skills, such as relaxation techniques, mindfulness, and stress management. Problem-solving skills are also taught to address challenges related to agoraphobia.
  4. Behavioral Activation:
    • Goal: Encourage increased engagement in positive activities.
    • Process: The therapist collaborates with the individual to identify and schedule enjoyable and meaningful activities. This helps counteract avoidance behaviors and promotes a more fulfilling life.
  5. Gradual Exposure:
    • Goal: Systematically confront feared situations.
    • Process: While ERP is a distinct technique, elements of exposure may be incorporated into CBT. The individual works with the therapist to create a hierarchy of feared situations and gradually confronts them, building tolerance over time.

Exposure and Response Prevention (ERP):

  1. Systematic Desensitization:
    • Goal: Reduce anxiety through graded exposure.
    • Process: The therapist and individual collaboratively create a hierarchy of feared situations, starting with less anxiety-provoking scenarios and progressing to more challenging ones. Exposure is conducted without engaging in the usual avoidance or safety behaviors.
  2. In Vivo Exposure:
    • Goal: Expose the individual to real-life situations.
    • Process: The individual is guided to confront feared situations in the real world. This may include going to public places, using public transportation, or engaging in activities that trigger anxiety. The therapist helps the individual resist the urge to escape or engage in rituals.
  3. Response Prevention:
    • Goal: Break the cycle of avoidance and rituals.
    • Process: The therapist works with the individual to prevent the typical responses to anxiety, such as leaving a situation prematurely or seeking reassurance. This helps disrupt the connection between anxiety and avoidance.
  4. Interoceptive Exposure:
    • Goal: Address fear of internal sensations.
    • Process: In addition to external exposures, individuals may engage in exercises that intentionally induce physical sensations associated with anxiety (e.g., increased heart rate). This helps them confront and tolerate bodily sensations without avoidance.
  5. Homework Assignments:
    • Goal: Reinforce learning and practice outside of therapy.
    • Process: Individuals are often given exposure exercises to practice between sessions. This helps generalize the skills learned in therapy to real-life situations.

In the treatment of agoraphobia, CBT and ERP are often integrated to provide a comprehensive and tailored approach. While CBT addresses cognitive aspects, such as negative thinking patterns, ERP focuses on direct exposure to feared situations to reduce avoidance behaviors. The combination of these approaches helps individuals develop coping skills, change maladaptive thought patterns, and confront feared situations with increased resilience. It’s important to note that therapy is typically individualized, and the specific techniques used may vary based on the person’s unique needs and progress.


Literary Devices


I asked ChatGPT about the metaphors in “Row, row, row your boat.”  I’m reevaluating metaphors. As much as I would like to go with a strict constructionalist reading of the song, I think it’s darker. It’s darker in my stories. My seas are choppy and rough. My paddle is always possibly lost in the current. My boat is sometimes thrown about in the uncontrolled waves caused by other peoples’ boats. But, ChatGPT says it’s all pleasant and engaging. I may be in the market for a new metaphor. What are your metaphors in your writing? Or in your life? In your own internal cheerleading? There are some good ideas below the “row row row” discussion.


Per ChatGPT:

“Row, Row, Row Your Boat” is a popular nursery rhyme and children’s song that is often used for singing games. The lyrics go:

Row, row, row your boat, Gently down the stream. Merrily, merrily, merrily, merrily, Life is but a dream.

The song is a simple and repetitive tune, often sung in a round. While it’s primarily intended as a children’s song, some people have interpreted the lyrics as having deeper meanings or metaphors. However, it’s important to note that the original intent of the song was likely to provide a pleasant and engaging experience for young children.

That said, if one were to interpret the lyrics metaphorically, different people might derive various meanings. Here are a few potential interpretations:

  1. Metaphor for Life’s Journey: The act of rowing a boat down a stream could be seen as a metaphor for navigating through the journey of life. The gentle and merrily repeated phrases suggest a positive and optimistic approach to facing life’s challenges.
  2. Metaphor for Cooperation: In a round, each person starts singing the song at a different time, creating a harmonious overlap. This could be interpreted as a metaphor for cooperation and working together, emphasizing the idea that life is better when people support each other.
  3. Reflection on the Nature of Reality: The mention of life being “but a dream” might be seen as a contemplation on the transient and illusory nature of life. This interpretation aligns with philosophical ideas about the impermanence of reality.
  4. Childhood Innocence and Imagination: The song’s simplicity and whimsical nature might be a celebration of childhood innocence and imagination. It encourages a carefree and joyful perspective, much like a child’s view of the world.

Ultimately, interpretations of metaphors can be subjective, and the intended meaning of “Row, Row, Row Your Boat” is likely to be light-hearted and child-friendly. If you encounter deeper interpretations, it’s likely that individuals are adding their own layers of meaning to the song rather than adhering to any specific original intention.

I next asked ChatGPT what some good metaphors would be for the journey of life.

Per ChatGPT

Metaphors for the journey of life often draw on common experiences, nature, and human activities to convey a deeper understanding of the complexities, challenges, and beauty of life. Here are some metaphors for the journey of life:

The Path or Road:

Metaphor: Life is a journey along a winding path or road.
Meaning: The path represents the course of one’s life, with twists and turns symbolizing challenges and choices. The journey is about navigating through different phases and reaching destinations.

The River:

Metaphor: Life is like a river.
Meaning: The river symbolizes the flow of time, with its currents representing the inevitable progression of life. Life, like a river, has its calm stretches and turbulent rapids.

The Seasons:

Metaphor: Life has seasons.
Meaning: Each season represents a different phase in life—spring for new beginnings, summer for growth, autumn for change and reflection, and winter for rest or challenges.

The Mountain Climb:

Metaphor: Life is a mountain to climb.
Meaning: Climbing a mountain signifies the effort and determination required to overcome challenges. The summit represents achievements and personal growth.

The Garden:

Metaphor: Life is a garden.
Meaning: The garden represents the cultivation of experiences, relationships, and personal development. Tending to the garden involves nurturing and caring for various aspects of life.

The Book or Story:

Metaphor: Life is a book or story.
Meaning: Each chapter or page represents a period in one’s life. The narrative includes various characters, plot twists, and themes that contribute to the overall story.

The Journey on a Train:

Metaphor: Life is a train journey.
Meaning: The train represents the passage of time and the experiences gained during the journey. Different stops symbolize milestones and significant events.

The Puzzle:

Metaphor: Life is a puzzle.
Meaning: Life’s challenges and experiences are like pieces of a puzzle. As one progresses, the pieces come together to form a complete picture.

The Dance:

Metaphor: Life is a dance.
Meaning: The dance symbolizes the rhythm and flow of life. Different steps and movements represent various experiences and relationships.

The Marathon:

Metaphor: Life is a marathon.
Meaning: The marathon signifies the endurance and persistence required throughout life. Milestones represent achievements, and the race is a metaphor for the journey’s challenges.

Metaphors for the journey of life can be powerful tools for reflection and understanding. Different metaphors may resonate with individuals based on their unique perspectives and experiences.

CBT, DBT, all the T’s


I asked ChatGPT How do CBT and DBT differ?

Here is what ChatGPT said:

Cognitive-Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are both forms of psychotherapy, but they have distinct differences in their approaches, goals, and techniques. Here’s a brief overview of the main differences between CBT and DBT:

  1. Founding Principles:
    • CBT: Developed by Aaron T. Beck, CBT focuses on identifying and changing negative thought patterns and behaviors that contribute to emotional distress. It’s goal-oriented and aims to help individuals develop more adaptive ways of thinking and behaving.
    • DBT: Developed by Marsha M. Linehan, DBT was initially designed to treat individuals with borderline personality disorder (BPD). It combines cognitive-behavioral techniques with mindfulness and acceptance strategies. DBT is particularly effective in addressing emotional dysregulation and self-destructive behaviors.
  2. Targeted Issues:
    • CBT: Widely used for a variety of mental health conditions, including anxiety disorders, depression, phobias, and more. It addresses dysfunctional thought patterns and behaviors associated with specific symptoms.
    • DBT: Initially developed for individuals with borderline personality disorder, DBT has been adapted to treat a range of conditions involving emotional dysregulation, impulsivity, and difficulties in interpersonal relationships.
  3. Mindfulness and Acceptance:
    • CBT: While CBT may incorporate mindfulness techniques, it primarily focuses on changing thoughts and behaviors. Mindfulness is not as central to CBT as it is to DBT.
    • DBT: Mindfulness is a core component of DBT. It involves cultivating awareness of the present moment without judgment. Mindfulness skills are integrated to help individuals tolerate distress and regulate emotions.
  4. Dialectics:
    • CBT: Generally does not emphasize dialectical thinking, which involves holding and integrating opposing viewpoints. CBT tends to work on identifying and changing distorted thoughts in a more straightforward manner.
    • DBT: Dialectics play a crucial role in DBT. It encourages individuals to reconcile and accept conflicting thoughts and emotions. This is particularly relevant in addressing the inherent tension between accepting oneself while striving for change.
  5. Treatment Structure:
    • CBT: Typically follows a structured, time-limited format. Sessions are focused on specific goals, and the therapist works collaboratively with the individual to identify and change negative patterns.
    • DBT: Often involves a more comprehensive and longer-term approach. In addition to individual therapy, DBT commonly includes group therapy sessions and coaching to address crises and maintain progress.

While CBT and DBT have different emphases, it’s essential to note that therapeutic approaches are often tailored to an individual’s needs. Some therapists may integrate elements of both CBT and DBT based on the client’s specific challenges and goals. It’s crucial to discuss your preferences and treatment expectations with a mental health professional to determine the most suitable approach for your unique situation.

Wake Me Up Before You Go-Go



In his daily coffee chat, Scott Adams suggested a reframe of the bad day. Instead of identifying the day or your mood as bad, identify it as deficient in dopamine. That is a pretty effective reframe.  Once you have identified a deficiency, he’s right in saying you want to correct it – as opposed to worsening it through non-action.

So in the “bad day” or “feeling bad” scenario, you would identify a way to increase your dopamine. That’s much better for me because I otherwise think of dopamine in a high level macro “that doesn’t really relate to the everyday” thinking. In the reframe, the need to increase dopamine gets matched with an action item and a metric.

Now, nobody is saying you need to run a marathon or become the healthiest eating person on the face of the earth.  You don’t have to go vegan or keto or anything primal. This isn’t a call for you to change your entire life. It’s just a reminder to DO SOMETHING.

If you’re feeling down or if your environment is down, do something. Just do something new or different to drum up some dopamine.

Something small will suffice. It doesn’t have to be a heavy lift. Not anything too hard.Here’s the ChatGPT info with my two cents thrown in here and there. Now, ChatGPT didn’t mention sex (or pre-sex, for the younger readers)(there are no younger readers), but I’m pretty sure you can throw it in a few places as a possible options. Or even just walking hand-in-hand or flirting with goo-goo-eyes on an app.

And that’s my last word on sex.

I hope your Saturday is steady and sure or moving in that direction.  Even if you have to pass through the unknown to get there. Of course.

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You know how…….?


You know how a song comes on and it’s a song you definitely forgot even existed. And you can’t believe you forgot about it. Because it sounds like something you’ve never heard.  But you know it so well now and you know all the words and you know how to dance to it so you’re dancing from the waist up as you sit at your desk. This song is everything. It’s different than all the other music. It’s new. It’s new to you now in this moment. And it has you smiling so hard you can feel your cheeks pushed out of your face because it defines that time in your life when you must have been with those people. And that person. And those people. And that person. And those people.

I love Spotify.

Happy Friday.

Yes. I am going back to work. #getbacktowork


Can’t stop checking your email?

Go trivial.


I asked the following question to ChatGPT: What can I do to stop obsessively checking my email? Tips from ChatGPT below followed by my two cents.
my question: What can I do to stop obsessively checking my email?


ChatGPT’s response: If you find yourself obsessively checking your email and want to reduce this behavior, here are some strategies you can consider:


Set Specific Times:

Allocate specific times during the day to check your email. Having designated periods for checking and responding to emails can help you regain control over the habit.

My  two cents: : Use Alexa and Siri to set non-annoying reminders throughout the day when it’s time to check or stop checking. Just ask them to set a reminder. It’s easy. Tell them to say something funny and they’ll say something funny.

Turn Off Notifications:

Disable email notifications on your devices. This can prevent constant interruptions and reduce the urge to check your email impulsively.

My  two cents: This is huge. Your phone should not be talking to you. Unless you are saving lives. Or giving rides. Or Mr. Taylor Swift.

Prioritize Tasks:

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Reverse Bucket Lists – Arthur Brooks x Rich Roll

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This conversation between Arthur Brookes and Rich Roll was a real good listen.

Rich Roll always provides transcript and time stamps, which is amazing. Topics with time stamps below.


00:00:00 Intro
00:00:32 Happiness Defined
00:02:11 The Three Macronutrients of Happiness
00:04:11 The Biggest Confusion About Pleasure and Enjoyment
00:08:32 The Struggle for Joy
00:14:52 Reverse Bucket List
00:16:16 Metacognition Defined
00:18:14 Choosing a Better Reaction: The Importance of Time
00:22:18 Developing Self-Awareness and Metacognition
00:25:06 The Limbic System’s Response to Threats
00:28:20 Ad Break
00:29:26 Making Uncomfortable Decisions for Personal Growth
00:35:20 The Evolution of Happiness
00:36:12 Reconnecting in a Relationship
00:40:32 Arthur’s New Book with Oprah
00:45:12 The Function and Purpose of Negative Emotions
00:48:35 The Neurochemistry of Schadenfreude
00:49:43 Guilt and Shame
00:53:35 The Genetic Basis of Happiness
00:54:43 Understanding Positive and Negative Affect
00:57:39 Different Profiles and Complementarity in Relationships
01:02:36 The Negativity Bias and its Management
01:04:36 The As-If Principle and Changing Emotional States
01:09:31 Depression, Rumination and Creativity
01:12:04 The Fear of Losing Oneself
01:13:59 The Crisis of Meaning
01:20:41 Finding the Answers
01:24:35 The Four Pillars of Happiness
01:32:00 Holding Opinions Lightly and the Attachment to Opinions
01:38:27 The Revolution of Love
01:41:15 Creating Happiness Teachers
01:45:01 Work as an Opportunity to Serve
01:47:03 The Importance of Serving One Person
01:49:25 The Magic of Love in Little Acts
01:51:07 Making a Public Commitment to Virtue
01:56:16 The Importance of Consistency and Values
02:00:27 The Role of Choice and Compatibility in Dating Apps
02:05:08 Finding Love on Dating Apps
02:06:46 Misconceptions about Happiness
02:11:27 Balancing Friendships and Family
02:13:53 The Temptation of Opportunities
02:15:54 Teaching Happiness
02:22:18 The Importance of Neuroscience and Psychology in Career Trajectory
02:22:50 Closing Remarks





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