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Even Snoopy has a sloped roof!

“Even Snoopy has a sloped roof.”
~ Ben Shapiro


I don’t mean any disrespect to the United States Secret Service. I just like Ben Shapiro’s humor. And his delivery. His timing is excellent. 

“Even Snoopy has a sloped roof.”  That was funny.  And Peanuts humor is always automatically fun, of course.  Everyone understands Peanuts. : ) 

Did I ever tell you that my editor was Charles Schultz’s editor? No kidding. She was. And she is just as amazing as you would think. Actually, she is even more amazing

So what a week in the news. OMG. First, and most importantly, Prime Days!  I took advantage of a few and hope you found good ones too. I got coffee at less than half the price I usually pay, so Y.A.Y.!  Yay assuming I did the math correctly. I will double check. 

And a Republican National Convention with literary surprises! My inner English Major woke up with that Vice Presidential pick. I’m sorry, Kamala. That had to have hurt. J.D. is pretty damn cool. I’m sorry. 

And then there was the whole business of the assassination attempt. Then Bob Newhart. 

My brother and I used to watch Bob Newhart, Mary Tyler Moore and Carol Burnett on the CBS Saturday Night Line up of amazing shows.  We were allowed to have a party in my parent’s bed. 

We made a tray of cheese and crackers and apple slices and peanuts and soda. We were allowed to take it upstairs and watch the shows in my parents’ bedroom. 

RIP Bob Newhart. And Mary Tyler Moore. And the rest of those folks. Those were good memories to have this week. 

I am trying to make my default fun, like Peanuts. Because why not try. Sure I might not be able to do it all the time. But maybe I’ll be able to do it a lot of the time. Just have fun. Stupid fun. Silly fun. Little bits and pieces of fun. 

My buddy told me about 5-3-1. It’s a gratitude exercise. The numbers help you remember the exercise.  I looked up 5-3-1 to find it’s origin and it’s here at the Center for Healthy Minds at the University of Wisconsin – Madison


Meditate 5 minutes per day. For many people, focusing on the breath or taking a break from your to-do list helps de-stress and calm the mind. 


Write down 3 good things that happened today. Previous research in individuals suggests a positive relationship between gratitude and higher levels of well-being.


Do 1 act of kindness. Whether it’s holding the door for the person behind you or paying someone a heartfelt compliment, generous behavior is not only good for the person receiving it, but also for the giver.

I will give some thought to my 5-3-1 for today and also the 5-3-1 coming up tomorrow. Then I will do it every day and nag my buddy to do it too and report his results.  It’s nice to pause and think about something current that is positive. It helps to infuse some good karma when you are getting alerts that some candidates are getting shot at and other candidates are getting Covid and yada yada yada.

La la la la la….. I can’t hear you….. see you all again in 5-3-1.

xoxoxo, d (and bella)




Want to change your mind?


A list of distractions for those in need. Always have a few distractions ready for when you need to avoid or escape a thought, obsession, urge or impulse. Or work.

  1. Read cartoons. Obv.
  2. Stand up if you are sitting down. Sit down if you are standing up. Do that ten times slow. Ten more if you didn’t feel it.
  3. Go to another room and give it an hour of attention.
  4. Look at the Top Billboard Hits for the year you were born. Do you know the songs? Try to remember when and how you came to know the songs. Listen to them online.Do the next ten or fifteen years. It’s really cool. And a good journaling opportunity.
  5. Text a heart or a smile or something really wild to a new friend. Then hope you didn’t really mess up.
  6. Do the same to an old friend. One you’ve already messed up on before so now it’s okay to mess up.
  7. Know – and notate – that messing up is always okay when texting a heart or a smile.
  8. Remember something specific you did with your grandparents, aunts and uncles. Try to nail down the year, the place, the people who were there.
  9. Jump rope (with or without a rope) for 60 seconds. Or march in place. Or jumping jacks. 60 seconds or count to 100. Do it a few times.
  10. Watch or listen to something that makes you laugh for an hour. Longer if you can. Shorter if you don’t have time. At least ten minutes of laughing.
  11. Use a timer for everything. Think about how that could change your life. Or not.
  12. Take a walk. Walk with purpose so your muscles know you’re awake.
  13. Look up your Social Security retirement options.
  14. Do a family tree. And a friend’s tree. And a family friend’s tree.
  15. Cast the movie of your life.
  16. Is the movie of your life a comedy or a drama? Decide the title.
  17. If your life was a documentary, what would be the hook?
  18. List the songs you heard in the car when you first started driving. Now THAT is a fun distraction! Men with big lapels!
  19. Describe your dream date.
  20. Your dream menu! What is your dream menu?
  21. Plan the next five breakfasts, lunches, dinners, mini-meals, noshes, grazings, whatever. Plan some upcoming food!
  22. How many times have you been in love? (Salacious details required) List please.
  23. Walk around the block.
  24. Change your passwords to make them more secure.
  25. Answer unanswered emails.
  26. Soduko!
  27. Make Mac ‘n cheese or something else with cheese.
  28. Put a load of clothes in the washer (set a timer for the transition-to-dryer)
  29. Find a ball. Dribble it, throw it, toss it, roll it. Play with the ball(s).
  30. Clean out one closet.
  31. Divide the big box of Cheerios into single serving bags.
  32. Walk the other way around the block
  33. Read your version of celebrity gossip.
  34. Check up on somebody.
  35. Check in with somebody.
  36. Hydrate.
  37. Look up the popular or award winning (or shoulda won) movies from when you grew up. Try to remember who you watched the movie with.
  38. Look up the popular or award winning (or shoulda won) movies from when you were out there just or still messing around. Try to remember who you watched the movie with. Careful this one doesn’t cause a fight.
  39. Boil eggs.
  40. Clean one bathroom’s counters, mirrors and handles.
  41. Look up some make up tutorials and put on a happy face. Or a runway face.
  42. Cosplay! Do it! Or at least check it out.
  43. Mani-pedi!
  44. List the people you love. And the people you love “that way.”
  45. List the cars you’ve driven.
  46. Name two things you can recite by heart.
  47. Recite one of the two things you named by heart.
  48. Look through pictures anywhere, phone, computer, albums, anywhere.
  49. Watch a show from when you were in high school and talk back to the tv.
  50. Shag. Marry. Kill. The guys from the Brady Bunch. Or the girls. Or a combination.
  51. Rehydrate with something inspiring or seasonal.
  52. Moisturize your cuticles.
  53. List the classes you even remember taking in college. List them. Now.
  54. Do a Personalized Alphabet of your own.A is for Affirm Your Interest
    B is for Bella going Bike Riding at the BeachC is for Cheerios
    D is for Distraction
    E is for Engage
    F is for FeelingsG is for a New Gym!
    H is for Hummus Hummus Everywhere

    I is for Insanity
    J is for January

    K is for OK!……

  55. Light a candle or two.
  56. Eat some hummus. But THIS time try it a different way. Yum.
  57. Write a note to someone and mail it at the mailbox.
  58. Walk to your nearest mailbox.
  59. Play with your dog the way your dog likes to play for an hour. NOT. Ten minutes.
  60. Did you save pages in any app or browser? Scroll through your saved pages at a relaxing pace. It’s like a theater of your favorites! It actually IS a theater of your favorites. You can watch your saves instead of just searching from saves. .
  61. Speaking of which, take screenshots. Let your screenshots talk to you. If you screenshot throughout the day or week, you can scroll through at the end and be entertained. Or scared. I guess it depends what screenshots you grab.
  62. Take a bath. With bubbles. Of course.
  63. Do anything involving Pop Tarts.
  64. Watch the MasterClass videos or Oprah’s Super Soul series, etc. For hearing from the person, as opposed to the podcast interview format.
  65. Do puzzles. Any puzzles. Yes. That will work. Yes. Anything you are doing, do more. Now.
  66. Are you distracted yet?
  67. List your favorite movies, favorites books, favorite shows, favorite YouTube, etc.
  68. List things you want to leave back in the old year.
  69. List promises you want to make to yourself and maybe to others in private.
  70. List the basic plots of the movies you would write with me if we could find the time to do it.
  71. List the clothes you need to pack for the beach. Or the clothes you need to change into for the gym. Or the clothes you need to donate because you are finished with them. Something is going on with your clothes. List that situation and figure it out.
  72. Go back to 68. You do me and I owe you one. That’s why 68 is better than 69.
  73. Laugh at something again. Twice.

Hope your Saturday is good or maybe even great at some point.
Stay warm and dry.
xoxo, d, and ruff ruff, Bella

Miswiring and neuroplasticity

Try out the back seat.

Check out Andrew Huberman’s Episode #AMA 16 – a question and answer episode. The segment on OCD is a great explanation and summary of where OCD is at now – in terms of being understood so we can hopefully hack the crap out of it.  I’m sure this content isn’t supposed to be shared since it’s behind a paywall. But I would love AH to come after me. I hope he does. : )

Seriously, as usual, Mr. Huberman has the most down-to-earth, understandable grouping of words ever in all I have heard and read on OCD. So he would want me to share this with you, I am sure.

This bit is at (00:26:58) Getting Closer to Unraveling OCD

QUESTION:  Are we any closer to finding the cause of OCD?

Well, I think we know what causes OCD. I think it’s pretty clear that OCD is some form of miswiring in the basal ganglia. The structures of the brain that are involved in go action and no go, withholding, action type behaviors.

And some malwiring of those structures to the dopamine reward system because here’s what’s interesting about OCD. OCD involves obsessions obviously. That’s the O in OCD. Compulsions, the actions. That’s the C in OCD. But in a kind of weird twist of the neurology, OCD is a situation where the compulsion does not remove the obsession. Rather, it exacerbates it, OK? The compulsion does not remove the obsession. It exacerbates it.

So unlike an itch that you scratch, with OCD, the scratching of the itch makes it worse, which is actually what we experience when we have a mosquito bite, which by the way, I absolutely loathe mosquito bites. It’s one of my least favorite things in life. I have about 3,600 and counting pet peeves. That’s definitely high on the list of those.

The obsessive compulsive disorder is one that really needs to be treated, frankly, neurologically. It’s one for which there are behavioral interventions, but it’s clear that adjusting the pharmacology of the neural circuits involved in OCD really can help. Again, there are behavioral treatments. But for severe cases of OCD, it’s just very, very clear that interventions, which include SSRIs, which have been demonized. A lot of people say, oh, selective serotonin reuptake inhibitors are terrible. Blah, blah, blah, blah. You know, the serotonin hypothesis of depression isn’t true.

Well, listen, the reality is this that all treatments for depression that are effective, which include SSRIs, in some cases, cognitive behavioral treatments, all of these sorts of things, which are shown efficacy, are all about what? They’re not about serotonin. They’re about neuroplasticity.

That’s why some antidepressants center on dopamine and norepinephrine. Others center on serotonin. They’re about neuroplasticity. They’re about changing neural networks. They’re not about neurochemical per se. But the neuromodulators such as serotonin allow an access point. They are a wedge into the neuroplasticity process.

Now with OCD, in order to overcome these malwirings, it’s very important to get plasticity. How do you get plasticity? Well, in my belief, you work with an excellent psychiatrist who can prescribe the appropriate dose of drug to release the appropriate amount of neuromodulator. Then, and this is really key, you have opened up the window for plasticity, but then it’s really important that the proper behaviors are engaged in.

And when I did an episode on OCD, I talked about what some of these are. For instance, the person is exposed to the stimulus that causes the obsession, or maybe the obsession arises spontaneously. They feel the impulse to complete the compulsion, the behavior, and they resist with the support of a therapist, but they’re doing this in the context of having elevated levels of serotonin or some other neuromodulator that then allows fewer trials of resistance.

Fewer times of needing to withhold the behavior that this person so badly wants to perform because it’s coming from within. It’s this compulsion literally. Then they are able to achieve plasticity more quickly. Perhaps also transcranial magnetic stimulation. So a conjunction of correct behavior, the withholding behavior, maybe a replacement behavior that’s often used. Use a replacement behavior with the appropriate neurochemical milieu is the solution to OCD.

Here’s some info about Andrew Huberman, if you don’t know him. Here’s the link to the podcast episode I stole the above passages from. It is the February 28, 2024 episode AMA #16: Sleep, Vertigo, TBI, OCD, Tips for Travelers, Gut-Brain Axis & More.

And more of AH on OCD. Plus articles. Right here.


Thank you to Andrew Huberman for making science make sense.

Thank you #scientists #doctors #research #neuroplasticity

xoxo, d and ruff ruff, bella


Skip to the good part!


Thank you to Mark Walmsley of the Arts and Culture Network, which is really a cool and fun organization.  I’ve met some super nice people through ACN. Mark interviewed me a while back about mental health and art, etc.

I have to warn you that this interview is definitely one of my most obnoxious, if not the most obnoxious.. But it’s just me who is obnoxious, not Mark. Mark is lovely and wonderful. I am just talking way too much and most of it is idiotic babble about nothing in my life that matters in any which way.  But in my defense, I had no idea we were recording that day and it was right after TMS and I was not good yet at thinking straight or talking without confusion and rambling. So don’t hate me based on this video. There are other reasons to hate me. Get to know me and find out for yourself.

The really important point I want to make by talking out loud about my experience is that Transcranial Magnetic Stimulation (TMS) changed my life entirely. I no longer have suicidal thoughts running freely through my head at all hours of the night and day as if they run my life.  TMS really helped me. I still need medication and good old CBT, but everyone needs good old CBT IMO. And most people need medication for one thing or another. Having to take a few pills a day to keep my mind out of the graveyard is okay by me. Because for the first time ever, I honestly believe I have enough of the right weapons in my arsenal to fight my worst and honestly, my only true enemy. None of my other enemies in life come anywhere close to suicidal thoughts. When you want to die more than you want to live, and when you feel that way chronically, it’s just really impossible to enjoy life and be grateful to wake up every day.  Some days, waking up is the exact thing you are trying not to do.  Even when life is good and you are rewarded for your hard work, your good deeds and your dedication to trying anything and everything, it’s hard to live when all you want to do is die.

But now, because of TMS, those thoughts are off in the background somewhere, just hanging out, but not bothering me.  If I didn’t have something helpful to share, I would shut up. I would shut up and just paint and write all day long. And hike. And bike. And snuggle with Bella. And love the people I love. And go to work. I guess we should mention work. But seriously, there are so many things that would be much more fun than talking about my bullshit brain and how hard it has worked to ruin my life. And how successful it has been.

But for decades, I sought out anything – any book, interview, article, anything to read by anyone who lived with a bad brain. Or some chronic condition that ruled their life. I needed to hear how other people  kept going and going and I have to say thank you to their voices because they helped me to stick around long enough to discover TMS.

So listen to the fun parts of the interview where we are joking around. And listen to the part where I say you need to talk to other doctors and other families.  Seriously, you’ll have to fast forward through some grating sections where I just ramble on about my work history and Capital Hill. Ho-hum-yada-yada. But definitely listen to the part about how you need to try anything new and different. And talk to anyone new and different. Because new people in your life will suggest new and different things. And you need new and different things if you are  feeling the same, decade after decade.  Day after day. Week after week. Month after month after year after five years, ten years, decades. You need something new if it has been too long.

I hope your Sunday is wonderful. I heard that Trevor and Jason are off today. Apparently today it’s Taylor’s turn to rule the world. I have to find something good to eat for that event. My approach to the Grammy’s is to get a really good snack, turn on the channel that shows the dresses, turn off the volume and write.

Because at the end of the day, I’m a writer. But now I’m a writer who makes plans for the future. Send me links to your writing retreats! I never thought I would say that and mean it. But I do. I am planning writing retreats!

Off to walk Bella. She likes TMS too.

xoxoxo, d (and Bella)

P.S. An important point I fail to articulate well is that your doctors and family – though wonderful and there for you and all the good things – are limited in their knowledge and experience. Their view of your situation, your resources, your capabilities and your options is limited in so many ways by their love for you, their limitations, their lack of knowledge, their own conditions, and their fear of losing you. For years, even trying to change a dosage would trigger “But I thought you were doing so well.” Family wanted to support me. But family also wanted for me to be great and stay great and not do anything to mess that up.  They wanted so much for me to just be better and not scare anybody anymore or take a chance that we might get scared again.

So ask other families what they have done and ask other doctors what they would do.  Honestly, I did not start to get the help that really made the significant difference in my ability to think, speak, work and live until I spoke with other families and other doctors. I am absolutely grateful to my doctors and my family for all of their support over the years. But they could only do what they knew to do. Me too. I only knew what I knew. You reach the limit on the breadth of knowledge there is in your circle of support.  So widen your circle.  Start with your virtual circle. It’s the easiest. Start there. 🤎


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





Use Your Words

Use Your Words

Here’s a sample list to start with.

I filled in a few cells. Maybe we could share the rest later with each other. I grow these lists each day in my journal, log, whatever you call it. Not all at once. I add them slowly throughout the day as the ideas evolve more organically. As I remember things I used to know or as I am reminded of feelings, memories, and all of that, I jot words down for revisiting later. Then, when I revisit later, I can see where I want to focus more attention or less attention. You get the drift. I can take what I’ve written and feed it into CBT, DBT, writing, word art, lyrics, dialogue, whatever.

Try it. Add your own words. I use Microsoft OneNote for this type of journaling because OneNote easily organizes into topic headings, subs, etc and because OneNote automatically updates.

I posted this over at Substack. I am checking out Substack’s Chat feature. If you’re over there, find me at Cartoons and Ketamine.

Happy Sunday!

xoxo, d (and bella)

I stole your chart.

Thank you to the fabulous creator of this really helpful chart. If it’s yours, please let me know. I would love to ask you questions about it!

What else…. it’s hard to think the day after Halloween. I know I ate sugar yesterday. I don’t recall feeling considerably different after all the sugar. I guess I eat enough sugar on a regular basis to support the occasional candy-fest. There were Snickers, Mounds, Butterfingers and Peppermint Patties.  There were a bunch left and now they’re in the freezer since all chocolate and pound cake is better frozen.

The nice thing about getting older and remembering less is that you forget there are Peppermint Patties and Peanut Butter Cups in the freezer. And then, one day, when you’re looking for that last bag of Edamame, you find a frozen well-sealed collection of Hershey’s minis.  And you think, thank you God for making me forget those were there. That was a nice surprise. Kind of like when you start wearing your winter jackets and you find cash in the pockets.

And gum.  And doggy poop bags. Tiny collections of cash, gum and doggy poop bags in all of my jackets.

At least I’m consistent.

Here’s a really good podcast from Mel Robbins. I am on my third listen of this particular episode. I may listen to it in the mornings for a while as a meditation. It’s really full of good instructions. I’ll list them below later.  She is just so easy to listen to and understand.  She talks about friends for a reason, friends for a season and friends for a lifetime.  It’s helpful.

And I like her six-month rule. This was helpful for learning boundaries.

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Easy to teach to parents and kids!
If they can remember to say ‘Alexa’ and not Siri.
Working on that now.

My best score yet. This thing’s addictive.

I still suck at the game where you guess which four words have a connection.  And it’s not timed so I can sit there for an hour thinking about how stupid I am. I wish everything was timed. At least I would give up after a reasonable amount of time. It’s more exciting that way. Easier to make bets.

Spelling Bee is also so frustrating. No bets on that one. And it also needs a timer. My score always indicates I have reached an amazing level but then says I need five more levels in order to be competitive.

A friend on Facebook – an acquaintance, I guess- posted his scores one day in games other than Wordle and it was so tempting to do all the puzzles. That’s what got me. Peer presssure. So now I do anything short. It’s really fun.  We just need timers on everything.

And I started watching one hour of a funny movie at night. That makes advancement far easier on the laughing front. And I’m so excited to see so much content out there. If you’re saying there’s nothing on, maybe you watch too much tv. I see a lot of stuff. And most of it looks pretty interesting and fun. Granted, not everything can be Breaking Bad or Game of Thrones or Sopranos. But laughing is just really fun.

Here are some other highlights from last week as I contemplate the week ahead.  Snippets from the diaries:

This past week was really fun for seeing old Reply All comics. I really appreciate when readers post those on social. It’s especially nice if it was funny or cute. It’s almost always true ten years later. And that is always a reassuring thought. It’s reassuring to know that the stupidity and laziness of ten years ago still rings true. : )

I love this cutie. Does anyone know who she belongs to? I really like her.

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

Somebody on Reddit wondered about how to remember that OCD thoughts aren’t real necessarily and may just be in your head.  I interpreted that very broadly to think about how I would answer it. So I thought about this question: how can you triage your thoughts instead of having to put up with them getting lodged in your head and looping?

Here is my response.

Write down the thought as soon as you have it. Call it anything, a note, notes, a journal or list as you go through your day. Write down your thought at the moment you have the thought. Use common words that are easy for you to remember. Make your own customized keywords that you can easily remember. You do not have to write a dissertation. Just jot down your thoughts in real time. It’s not poetry. At first. It’s just raw pieces at first. For some people.

Give it enough detail that YOU can come back to it later and understand what you are referring to.  Capture the time and date. Done.

Then come back to it when you can and make a decision on what you think about it or how it feels or what you might say if the same thing happened to you. And write that down.

On future bad days, at the moment the thought comes up, jot it down. Now do a keyword search for your common words related to that thought. You will get a list with links of all the times you mentioned that. You mentioned it because you were having those thoughts.  And you totally analyzed it so many times, you can see from your own documenting. So now you can just note that this is a thought that comes up a lot and this is how you deal with it. A record of what works and what does now work.

And maybe the writing has been therapeutic or insightful for you. Maybe for multiple reasons. Maybe it helps you to keep those great work ideas straight.

And for some of you, like me, the writing part becomes the most fun thing. You pleasure yourself by writing. And no, you perverts. I did not say I pleasure myself while writing. I did not. Not that there’s anything wrong with it.

The cool thing is that in addition to practicing daily writing of any kind, taking these notes of your thoughts means you have research data.

Because every day you are collecting research about your mind. Just search for one of your own customized common keywords – custom to whatever you’re searching for – and you should get a bunch of your writing dating back from whenever your started, a lot of it real time. You can tell how much you ate, drank, smoked, swallowed, licked, bit, oooh. Now it’s getting gross.

You get it. You can take a calendar, notes, list, a timeline, any recorded real time memories and gather the data to become poems or books or memoirs.

I’m sure that response had nothing to do with the question.  Try it anyway. You might find it entertaining.

Happy Sunday evening.

I love watching funny movies now. Thank you, scientists.

xoxoxo, d and bella


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