Couples Therapy for substance use
If one partner has a drinking or drug problem and they're in a relationship, the partner is part of the treatment whether anybody signs them up for it or…
Group Therapy: what actually happens in the room
Group therapy is the treatment I refer to most often and the one patients fight me hardest on. The fight is almost always the same: I don’t want to talk about my problems in front of strangers. The answer is…
Internal Family Systems (IFS)
IFS (internal family systems, the therapy model that asks the patient to relate to different aspects of himself as if they were distinct internal parts…
Addiction, Explained
Addiction is what happens when the brain's reward wiring gets dragged hard in one direction.
Acceptance and Commitment Therapy (ACT)
ACT (acceptance and commitment therapy, a “third-wave” behavioral therapy that grew up out of the CBT lineage in the late 80s and 90s) has built itself into a real piece of the evidence base over the last twenty-five years, with…
Hair loss: what works, what’s hype
Finasteride, dutasteride, minoxidil, PRP, microneedling, transplants. The math of male pattern hair loss, the meds that bend it, and the things sold to you that mostly don't.
Prolonged Exposure for PTSD
Prolonged exposure is one of the two gold-standard treatments for PTSD (post-traumatic stress disorder, the trauma-spectrum condition that follows certain…
Pristiq (Desvenlafaxine)
Pristiq is what happens when you take Effexor, skip a metabolic step, and sell it as a new drug. That's not a dig, that's the actual mechanism.
Self-Harm in Adult Men
Self-harm in adult men is a thing we don’t talk about much, because the cultural picture of self-harm is a teenage girl with a razor and her arms, which is one version of it and not the most common version…
Body Dysmorphic Disorder in men
Body dysmorphic disorder in men is more common than most clinicians catch, and it shows up differently from how the textbook describes it because the…
The Difference Between Depression and Just Being Sad
Not every bad day is depression and not every hard week means you need medication.
Alcohol Use Disorder diagnostic criteria
Most guys who have alcohol use disorder don’t think they have it, because they think alcoholism means falling-down-drunk and missing work, and they’re not doing that. They’re functional, they’re employed, they drink every night, and they meet criteria for AUD…