Psychobabble

Hannah Spier, MD
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Psychiatrist analyzing how cultural trends and modern therapy incentivize dysfunction. hannahspier.substack.com

  1. #62. Borderline: The Female Version of Antisocial

    17 HR AGO

    #62. Borderline: The Female Version of Antisocial

    Are we misdiagnosing female predators as "patients"?In this video, I explore a provocative but clinically grounded theory: that Borderline Personality Disorder (BPD) is often the female expression of Antisocial Personality Disorder (ASPD). While we have no trouble identifying the "Language of Force" in the male predator, society often falls for the "Language of the Heart" when it comes to women.Using the viral case of a young woman named Deja, I break down the Strategic Regression and Tactical Tantrums used to establish affective dominance over others. We move past the "victim-patient" model to restore the dignity of agency, analyzing how hyper-neuroticism can be used as a weapon system. I also released the full recording of our latest clinical live session with Tom Golden, where we unpack why men don’t process grief the way modern psychology assumes and what actually works instead. It’s one of those discussions that shifts how you interpret behaviour almost immediately. If you’ve ever felt that the standard framework doesn’t quite fit, this is worth watching. You can access it here (paid subscribers), and the next live session is on April 12th with Jim Nuzzo, focusing on a practical approach to men’s health. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    20 min
  2. #61. Challenging the 'ADHD Was Always There' Narrative

    4 DAYS AGO

    #61. Challenging the 'ADHD Was Always There' Narrative

    ADHD did not expand by accident.In some U.S. states, nearly 1 in 5 boys have been diagnosed. Adult diagnoses continue to rise. The standard explanation is simple: “It was always there — we’re just recognizing it now.”But genuine medical conditions do not behave this way.In this episode, I trace the historical evolution of ADHD from a rare and severe childhood condition to a lifelong, broadly defined neurodevelopmental diagnosis. We look at the DSM revisions that expanded criteria, the shift from hyperactivity to inattention, and the moment adult self-report became sufficient for diagnosis.More importantly, we examine the forces that benefited from this expansion Become a Psychobabble Insider and join us Saturday the 28th of March at 3 PM Eastern for a Live Clinical Session on helping men grieve with Tom Golden! 0:00 The Epidemic of ADHD Diagnoses and Medication0:20 Challenging the 'ADHD Was Always There' Narrative1:02 Why Prevalence Data Disproves the 'Always There' Argument1:40 DSM Revisions and Shifting Diagnostic Criteria2:24 ADHD as a Reflection of Institutional Demands2:52 The Intellectual Roots of Psychiatric Diagnosis: Wundt's Lab3:39 Sir George Still's Early Description of 'Abnormal Incapacity' (1902)4:47 From Brain Damage to Dysfunction: Early Diagnostic Evolution5:35 The Baby Boom and the Need for Conformity: Shifting Focus to Hyperactivity6:46 DSM 2 (1968): Hyperkinetic Reaction and Teachers as Gatekeepers7:59 DSM 3 (1980): The Pivotal Shift to Attention Deficit Disorder (ADD)8:58 DSM 4 (1994): Broadening Criteria, Subtypes, and 'Horoscope Questions'10:24 The Dangers of Subtypes, Spectrum Disorders, and Inclusivity in Psychiatry11:15 Institutional Priorities Driving Diagnostic Expansion12:44 DSM 5 (2013): Redefining ADHD as a Lifelong Neurodevelopmental Disorder13:30 Modern Schooling and Affluent Areas: Why This Diagnosis?14:22 Benefits for Parents: Replacing Moral Judgment with Medical Explanations15:52 Benefits for Teachers: Diagnosis as a Recourse for Behavioral Issues16:47 Psychiatry's Quest for Legitimacy and the Role of ADHD17:39 The Pharmaceutical Industry: Amplifying ADHD Diagnosis18:08 The Role of Identity: ADHD as a Path to Redemption and Status19:12 Why ADHD Grew: Solving Multiple Problems for Many Stakeholders20:20 The Origin of Stimulant Medications: War and Addiction21:20 How Stimulant Medications Work (and What They Don't Do)22:31 Non-Stimulant Medications: Mechanisms and Misrepresentation23:58 Withdrawal Effects, Side Effects, and the Dangers of ADHD Medication25:04 The Core Question: Medicalizing Normal Variants This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    26 min
  3. #60. The ADHD Surge Adult Women

    22 MAR

    #60. The ADHD Surge Adult Women

    ADHD is officially classified as a neurodevelopmental disorder: a lifelong brain condition said to be present from birth. But despite decades of research, there is still no biomarker, no diagnostic brain scan, and no consistent neurological abnormality that can reliably distinguish an “ADHD brain” from a normal one.In this video, I examine why adult ADHD diagnoses have surged, especially among women, and why the evidence increasingly suggests that what we call adult ADHD maps far more closely onto extreme personality traits than to a discrete brain disorder. Become a Psychobabble Insider and join us Saturday the 28th of March at 2 PM Eastern for a Live Clinical Session on helping men grieve with Tom Golden! 0:00 The Appeal of an ADHD Diagnosis and Redemption0:38 Questioning ADHD as a Neurodevelopmental Disorder1:29 Initial Red Flags in ADHD Diagnosis Narratives2:10 The Four Archetypes of ADHD Prevalence3:32 The Expanding Umbrella of ADHD Subtypes4:15 ADHD Diagnosis: Lack of Biomarkers or Brain Scans4:56 Challenging the 'Neurodivergent' Claim in ADHD5:53 Brain Volume Differences: Personality Traits vs. Pathology6:39 Environmental and Cultural Impact on ADHD Rates7:32 Women's Self-Diagnosis and the Hereditary Link8:23 Personality Traits as Predictors of Life Outcomes9:02 Deconstructing 'ADHD Symptoms' as Extreme Extroversion11:28 Impulsivity and Distractibility: Low Conscientiousness13:10 Fidgeting, Anxiety, and Mood Swings: Neuroticism14:19 Adaptive Task Switching vs. Fixation: Openness16:20 The Concept of 'Symptom Masking' and Emotional Pain17:58 The 'Anxious, Scattered Mother' and Personality Profiles19:55 Adult ADHD as a Manifestation of Extreme Personality20:25 Psychiatry's Influence on Cultural Expectations This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    22 min
  4. #59. Girl Rotting, Heterofatalism & “Decentering Men”

    15 MAR

    #59. Girl Rotting, Heterofatalism & “Decentering Men”

    I am joined by ​⁠Janice Fiamengo, ​⁠Tom Golden, and James Nuzzo to analyze a "folder of awful" containing various feminist buzzwords and social media trends. If you want to go deeper, here is the recording from a live session with Psychobabble Insiders,. These live discussions are where we can slow down, go through the clinical details, and answer questions directly. If you’d like to listen to the recording — and join future live sessions — you can find it here. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    55 min
  5. #58. Dissecting the 4 Major Obesity Delusions

    11 MAR

    #58. Dissecting the 4 Major Obesity Delusions

    Obesity is increasingly explained through hormones, genetics, metabolism, and microbiomes. These explanations sound compassionate, scientific, and non-judgmental — but they often fail to explain what we actually observe and definitely fail those who want to lose weight. Become a Psychobabble Insider and join us this Saturday the 14th of March at 3 PM Eastern for a Live Clinical Session on psychiatric medication! 00:00 The Hard Truth: Obesity Is Psychological01:57 Lie #1: The "Slow Metabolism" Alibi02:51 The Truth About Thyroid Issues04:40 Lie #2: The "Fat Gene" & Family Habits06:58 Lie #3: The Microbiome "God of the Gaps"10:10 Lie #4: The Starvation Mode Myth14:30 Why Your Skinny Friend Stays Thin15:50 Insulin: Signals vs. Calories16:50 The "Food Noise" & GLP-1 (Ozempic)22:50 Conclusion: The Alcoholism Comparison This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    24 min
  6. #57. Psychiatry Made the Bipolar Child Inevitable

    8 MAR

    #57. Psychiatry Made the Bipolar Child Inevitable

    To question a diagnosis today is to trigger a moral reaction.In contemporary psychiatry, diagnostic categories no longer function merely as clinical tools. They increasingly operate as moral identities, conferring legitimacy, status, and exemption from blame. When criteria are questioned, the response is often not clinical disagreement but moral accusation. Upgrade and join us this Saturday the 14th of March at 3 pm Eastern for the next Live Clinical Case Session on psychiatric medications In this video, I trace how bipolar disorder transformed from a rare and unmistakable illness into a broad diagnostic spectrum, and how that transformation reshaped psychiatric practice itself. From Kraepelin’s manic-depressive insanity, through DSM standardization, to the rise of the bipolar spectrum and the invention of the “bipolar child,” this is an account of how diagnostic boundaries eroded under cultural, institutional, and professional pressure. 00:00 Diagnosis as Moral Status03:00 How Bipolar Became a Checklist04:50 The Spectrum Explosion09:50 The Bipolar Child14:50 The Cost of Inclusion This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    18 min
  7. #56. How Borderline Was Rebranded as Bipolar

    25 FEB

    #56. How Borderline Was Rebranded as Bipolar

    I explain how traits once understood as borderline pathology were gradually laundered into bipolar disorder — through expanding criteria, rapid cycling, and the replacement of personality with biology.This isn’t about denying suffering.It’s about why diagnosis matters, how boundaries collapsed, and what it costs. Upgrade and join us this Saturday the 28th of Febuary at 3 pm Eastern for the next Live Clinical Case Session on psychiatric medications: When, How and How to Taper Safely. 00:00 – How mania is portrayed01:00 – What real mania actually looks like03:40 – Performative emotion vs psychosis05:45 – Why mania isn’t happiness07:30 – What real bipolar patients experience09:10 – Diagnosis as moral status10:00 – Rapid cycling and diagnostic collapse12:30 – Borderline traits relabeled as bipolar15:10 – Why psychiatry prefers bipolar This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    17 min
  8. #55. When Dark Traits Drive Paternal Alienation

    11 FEB

    #55. When Dark Traits Drive Paternal Alienation

    Most so-called “high conflict” divorces are not what people think they are. The term suggests two volatile adults locked in mutual chaos. But in a significant subset of cases, what looks like dysregulation is strategic. It is controlled, reputationally aware, and often concealed behind the language of concern, therapy, and child wellbeing. In this episode, I examine how some separations become arenas for status repair and control after narcissistic injury. Drawing on trait-based personality psychology — particularly the Dark Tetrad — I outline why diagnostic psychiatry and family courts frequently misread these dynamics, and why well-intentioned interventions can unintentionally strengthen them. If you have lived through this, you will recognise the pattern.If you are trying to understand why standard advice keeps failing, this will clarify why. Free material is about recognizing patterns. The paid tier exists for a different purpose: applying that understanding to real situations. Psychobabble Insiders are invited to take part in live clinical case sessions twice a month, so join us this Saturday for a “How-To” on anxiety. This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit hannahspier.substack.com/subscribe

    30 min
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About

Psychiatrist analyzing how cultural trends and modern therapy incentivize dysfunction. hannahspier.substack.com

Information

  • Creator
    Hannah Spier, MD
  • Years Active
    2023 - 2026
  • Episodes
    71
  • Rating
    Clean
  • Copyright
    © Hannah Spier
  • Show Website
    Psychobabble

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