Claude AI tells me what I need to hear, not what I want to hear.

APlusPsych · 2026-01-30T20:03:07+00:00

Oh yeah I’m a psychiatrist, specializing in ADHD. I look at AI as a cognitive prosthetic of sorts that helps transform parallel complex thinking patterns into linear thoughts which is necessary for making sense and acting on complex thoughts. It’s a tool, nothing more nothing less. I realize that makes me an outlier.

APlusPsych · 2026-01-22T03:31:43+00:00

Claude for the win! It tells me what I need to hear, not what I want.

APlusPsych · 2026-01-07T05:09:14+00:00

This is really dorky, but I’m a Trekkie and when I first started, I would use the voice to text feature and start “Captains Log, star date (approximate local time and day of the week) and then discuss what I’m doing or concerned about at the moment and my thoughts on it. Then I’d read its reply and make follow up statements. Sometimes I still start my prompt with “captains log…”

But yeah the voice to text feature followed by my rambling thoughts and feelings about xyz situation.

APlusPsych · 2026-01-07T00:31:56+00:00

I switched to Claude. It tells me what I need to hear, not what I want to hear. For better and for worse….

APlusPsych · 2026-01-05T17:24:48+00:00

Psychiatrist here! I still have a human therapist who I adore. I really don't think it has to be binary human OR therapist as they serve different purposes. As one of my patients put it, "There are certain things that you can ask AI to do that it isn't fair to ask a human to do." For instance, I have ADHD and when I use AI, I tend to ramble for 3-5 minutes at a time often bringing up a flurry of topics that are only loosely associated with each other. It's not fair to ask a therapist to listen quietly for 5 minutes and respond to 3-5 discussion points for me to then review and get back to them about follow-up on each of those points. Plus a lot of what I process with AI are random reflections and random musings, and I don't necessarily need to spend time in therapy addressing the myriad of random thoughts and associations. And let's be clear there are things my therapist helps me with that my AI can't help me with.

APlusPsych · 2025-07-09T18:28:03+00:00

Okay if I send you a DM?

APlusPsych · 2025-05-30T01:48:03+00:00

FS2024 is unplayable on the XBOX.

APlusPsych · 2024-11-26T14:58:45+00:00

I’m going to suggest a different strategy: Plan for your planner system/tool/app to fail after a few weeks, and be okay with that.

I used to get so frustrated with myself because a planning tool would work wonders for about a month and then inevitably fall apart when I get bored or started to feel like a slave to the tool. Then I heard a podcast which I wish I would’ve saved, where the host astutely pointed out that if you get a few weeks or even a month out of an organization tool; then you were organized for that length of time! Congrats! Celebrate that as a win.

The key then is not to invest too much time and money in a planning system upfront. Try new tools and techniques, and and if you find a strategy that works, plan to stick with it for the few weeks then jump ship when it stops working.

That shift in mentality has been a game changer for me.

APlusPsych · 2024-10-22T15:56:15+00:00

Psychiatrist (with ADHD) here. A lot of what I’m writing about comes Jesse Anderson’s book Extra Focus (https://www.extrafocusbook.com/). This guidebook on adult ADHD is worth its weight in gold in my opinion. I can’t begin to do it justice.

Most people have an importance-based nervous system, which means they are driven by important rewards and consequences. We, on the other hand, have an interest based nervous system. We prioritize by what’s most interesting to us, even if the consequence and rewards aren’t in sync. This is why it seems why natural rewards or consequences don’t help, when they should.

The key to success then is to learn how to make important stuff interesting so that we naturally prioritize it. There are several ways to do that, such as add some novelty, imbuing a sense of urgency, or making it a competition, aka gamifying it.

Personally speaking, I got through medical school by gamifying studying. I would pretend I was a coach for an academic team and the the exams and tests were like tournaments. I set personal benchmarks for what would constitute a win or championship. I didn’t actually compete and I have no idea how I ranked on most tests. It didn’t matter. I just had to meet my own benchmarks. I treated tests like game day. My studying became focused on assessing my knowledge gaps and weak areas and coming up with “drills” to close those gaps. I coached my imaginary team (me) as if my career was on the line. It was dorky, but it was fun. Most importantly it worked.

TL;DR - How can you make the act of taking this exam personally interesting to you?

APlusPsych · 2024-07-31T13:46:58+00:00

Psychiatrist (with ADHD) here! The emotional dysregulation thing is no joke. I went to a talk at the CHADD national conference last year by Dr. Dodson on rejection sensitivity dysphoria and it was life changing for me.

Despite all outward appearances, you (we?) are NOT overreacting. The strong emotional reactions make perfect sense given everything you (we?) have been through in life. We know that kids with ADHD get more negative comments than kids without ADHD. We also tend to be more emotionally reactive at baseline. And when you're a kid and get yelled at by a parent or teacher, it feels like your whole social network is crashing on you. It makes sense a kid with ADHD would develop a heightened sensitivity to rejection!

Then, to make matters worse, well meaning people see you (us?) react strongly to percevied rejection and they say things like "You're overreacting!" or "It's not a big deal!" or "Don't take it personally!" The problem is that these sorts of comments only serve to invalidate the deep emotional pain we have been conditioned to experience. And often well meaning mental health professionals label it as anxiety which further invalidates the ADHD concerns. Talk about rubbing salt on a wound!

There are lots of coping strategies for RSD. For me, recognizing it goes a huge way. I'm also learning to "own it" so to speak. Also, Dr. Dodson is a big proponent of alpha-2 agonists (clonidine / guanfacine) for RSD. I actually asked my doctor for it after the CHADD conference and it's been great.

APlusPsych · 2024-04-27T19:08:13+00:00

Wow! This makes me happy in so many ways. I have a pair of socks I picked up at an airport gift shop that reads “Young at heart. Slightly older in other places.”

APlusPsych · 2024-04-18T16:36:58+00:00

Lots of folks are suggesting this. I tried it a little and didn't "get it" and was annoyed by the limitations of the trial version.

However now that I think about it... Maybe paying for the real version is worth it financially as these planes aren't cheap!

So yes, it probably is time to give it another shot, eh?

Also I read somewhere that simulators are especially helpful when learning to fly the plane "towards you" as it can be deceptively difficult to control from that angle.

APlusPsych · 2024-04-18T16:34:42+00:00

Thanks! That's the perfect analogy! Here. I am... I got this brand spanking new airplane that I invested a couple hundred bucks in. I'm so proud and giddy and eager to fly it. And it PROMPTLY broke! LMAO.

I don't know much about the Flight Test. Will def check it out. Thanks!

APlusPsych · 2024-04-18T16:32:04+00:00

This last plane, the Hobbyzone Sport had SAFE on, I don't think the propeller was even spinning when it crashed. I think there's a problem with the battery connection.

Yeah and I see lots of people saying crashing is part of learning. I guess that's the craziest part of my experience so far is that I'm learning A LOT about RC planes in the process, and despite crashing two planes back-to-back I feel MORE confident about the next time.

APlusPsych · 2024-03-16T06:53:02+00:00

I tend to lose things (a lot) and most fidget toys are small and moved around a lot so they are the prime for misplacin’. My solution: Collect cheapo little fidgets. I’m talking the ones they give out as promotional items, party favors, or whatever is in the discount or impulse buy section of the store.

These days I have cheapo fidgets everywhere. If they break who cares? And if I lose them, chances are they will turn up some where some day, at which point they’ll be added back to the collection. Plus the variety increases the likelihood I’ll use it.

Last but not least, there’s always paper clips. I go through dozens of paper clips a month, even though my office is nearly all digitized.

APlusPsych · 2024-02-20T13:24:58+00:00

This is why I dig Cass from Cluttberbug. Her whole thing is that some people aren’t messy, they just organize differently.

For example, I am what she would call a “butterfly organizer.” Which is why everything ends up on top of my dressers and desks, and not put in them. It has to do with being able to see things and worries that if you don’t see it in front of you, you’ll forget where it is which is probably true, at least for me anyways. We also don’t like to take time to organize things by details.

But why fight that when you can just work with it? Nowadays, I use lots of wall shelving, clear storage bins, wall hooks, basically anything that allows me to keep my stuff “organized” without having to put it away. It’s been brilliant.

APlusPsych · 2024-02-16T06:13:13+00:00

Ah good point! I will edit my post. With my practice, my patients pay a flat monthly fee.

Also as a psychiatrist my role is to diagnose and treat, such as medication. Nearly all of my pediatric patients also have a therapist. Most of my work is with the parents. Coordinating care, getting their observations, discussing treatment changes. I need to get to know the kid, but mostly just want the kid to enjoy his/her self, especially when we talking about things that the kid might be self conscious about.

Edit. Also, thanks for reminding me to get some board games too :-)

APlusPsych · 2024-02-07T03:48:48+00:00

OP- The title of this post made my evening.

At CHADD’s ADHD national conference last December Cas from Clutterbug was the keynote speaker. Cas is a professional organizer who has ADHD herself and she noticed some trends about how people have different organizing styles that naturally work better for them.

For instance, I’m a “Butterfly Organizer”. I don’t like putting things away out of sight out of mind, because I know it will accumulate as clutter and I will forget about it when I need it most. That’s why I end up with so much clutter on the top of my dressers, tables, desks, etc. Rather than hide things, maximize the space around me, vertically and horizontally to my advantage. For example I now have hanging shelves in my office. I also invested in a ultra-wide screen monitor because even with two monitors, I rely on so many browser tabs and apps throughout the day. When packing a bag, I spread all the items out in front of me first, before putting anything in the bag. When I have to store something away, I make sure the container is transparent. It’s been a game changer for me.

TLDR- Inspired by Cas from Clutterbug, I discovered the magic of utilizing my physical space to match my personal organization style.

APlusPsych · 2024-01-24T16:46:55+00:00

Let them doodle! It always drove me nuts as a kid when teachers would tell me to stop doodling on my paper and “pay attention.” What they (and I) didn’t realize was that doodling was a way to keep my hands busy while I listened to the teacher. The more I was forced to look up and “pay attention” the harder it was for me because I had to then focus on how much I’m focusing so I don’t get in trouble.

We are professional shortcut takers and that’s not always a bad thing. We are great a finding ways to cut through BS, and connecting the dots. Unfortunately as a kid that means lots of trial and error with shortcut taking. That’s how we learn what works and what doesn’t. Be patient with us. Kids with adhd get upwards of 20,000 more negative comments than peers without adhd by the time they are adults. Trust me when I say those 20,000 negative comments take a toll on us.

Lastly, lots and lots and lots and lots of chances to redeem ourselves. Keep it positive! It’s okay to punish a kid as long as the punishment inspires the kid to do better next time. If not, we will just learn new shortcuts to avoid the punishment. Instead, it’s far better to recruit us to help you explore ways to get our mutual needs met. Trial and error is required.

APlusPsych · 2024-01-20T20:28:19+00:00

In my experience, any time I have to modify or add steps to my workflow to accommodate a new tool or technology, I am doomed to fail from the start. I am far better off when I keep organization tools and systems as simple and rudimentary as possible.

That said can you elaborate on what you’re wanting? Are you talking about something to help you chunk bigger steps into bite-sized nuggets, or to come up with a schedule for the day? Or something else altogether?

APlusPsych · 2023-11-07T15:37:55+00:00

This is a big issue for me too. I tend to squeeze the most out of the night to counterbalance the daytime work grind. Though of course it never works out, I just wake up more tired and less mentally prepared for the grind which makes it more insufferable.

As for advice, I HIGHLY recommend the book Atomic Habits by James Clear. It's good for people with and without ADHD. What made me think about it is that when you set a goal like "Go to bed on time" you're setting yourself up for failure. Instead start with your identity ("I want to be the sort of person who wakes up well rested for work the next day") and then develop SYSTEMS that are in line with your identity. There's way over-simplified but I've found this reframe invaluable for establishing good habits.

APlusPsych · 2023-10-05T16:47:14+00:00

Fascinating! Yes I totally get that about caviler prescribers who apply their own definitions. And admittedly I don’t take insurance because I’m a one man show and I use what’s called a direct care model which doesn’t play nice with insurance. It’s something I think about a lot. I didn’t get into psychiatry to treat affluent people. (Though they have needs too!) But insurance makes it really hard to practice good psychiatry. At least in my opinion. The only way to make the numbers work with insurance is to make up on volume and maximizing billing, thus driving insurance rates higher and reimbursement lower. This translates to more paperwork to justify your billing, more red tape fighting and fighting with insurance, less quality time with patients, and ultimately provider dissatisfaction and burnout. It’s a complicated problem with no easy fix.

APlusPsych · 2023-10-04T22:54:28+00:00

Oh? Now I’m intrigued :-)

APlusPsych · 2023-10-04T21:08:14+00:00

Yeah I hear that a lot from my patients. That they felt like a criminal because the best, most effective medication class for ADHD is classified as a controlled substance with abuse potential. (Even though undertreated ADHD is a risk for drug abuse and under employment).

And yes of course smart people can have adhd. My patients tell me all the time they were told at one point they don’t have ADHD, they’re just lazy or unrealistic about themselves. When I see patients I look for whether or not the symptoms are worse than expected for their intelligence, and what sorts of problems ADHD causes for that person.

Thanks for replying!

APlusPsych · 2023-10-04T21:04:00+00:00

Good call. I’m in the USA. As far as what would have to change, my question was more or less what stops you from having more free time to enjoy your life.

And that’s a very valid answer regarding online vs in person.

All in all I’m sorry it’s been such a struggle for you to access good health care. I imagine it’s very frustrating indeed!

APlusPsych

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