The Blog · Clinical insights · 59 essays
You don’t need to be fixed.
you don’t need permission either.
Field notes from thirteen clinical settings — on narcissistic abuse, clinician burnout, the quiet economics of American healthcare, and the software that should have existed years ago. No wellness poetry.
( 01 ) Essays
Long-form on clinical systems, power, and the myth of self-improvement.
( 02 ) Field notes
Short entries from inside thirteen clinical settings — what worked, what didn't, why.
( 03 ) Frequency
2 / per month
( 04 ) Voice
CLINICAL authority
STRUCTURAL skepticism
no poetry
STRUCTURAL skepticism
no poetry
Latest · 05
Recent essays.
C01Apr 30, 2026
Five Months at Saint Francis: What Managed Medicare Cost My Family
My dad has been at Saint Francis for almost five months. The hospital has been a model of patient engagement. The insurance company has been a wall. This is what managed Medicare actually does to families — with the data.
Managed MedicareMedicare AdvantageHealthcare System
C02Apr 27, 2026
When Networking Groups Become Hunting Grounds: Dark Triad Personalities, Groupthink, and the Cult Mechanics of Professional Belonging
Why professional networking groups produce trust as a function of attendance — and why that structure has been exploited by serial offenders, financial predators, and cult leaders for decades.
dark triadnarcissismpsychopathy
C03Apr 21, 2026
Narcissism in New York Real Estate: How Antagonistic Personality Styles Fuel Predatory Agents, Brokers, and Landlords
A clinical and investigative look at narcissistic and antagonistic traits in NYC's real estate industry — from predatory agents to deed-theft rings, slumlords, and institutional landlords — with citations and survival tools for New Yorkers.
Personality DisordersHousing JusticeNew York
C04Apr 17, 2026
Why Your EAP Has a 3% Utilization Problem (And What Behavioral Science Says to Do About It)
EAPs cost employers thousands per employee annually — yet 94–97% of that investment sits untouched. The problem isn't that employees don't want help. It's that the system wasn't designed for how human brains actually work.
behavioral economicsEAP utilizationemployee mental health
C05Apr 16, 2026
Schizoid Personality Disorder: What Clinicians Miss and What Clients Are Trying to Say
Schizoid personality disorder is one of the most misunderstood diagnoses in clinical practice. Here's what the lone wolf is actually telling you — and how to actually help.
schizoid personality disorderpersonality disordersclinical practice
Archive
Everything else.
Every published essay since 2023 — chronological, same register throughout.
- Apr 15, 2026The Attrition Death Spiral: Why Recruiting More Clinicians Won't Fix Behavioral Health's Workforce Crisis
- Apr 14, 2026Dependent Personality Disorder: What It Looks Like in Care Settings (And Why the System Keeps Missing It)
- Apr 10, 2026What Burnout Actually Is — And Why Recovery Isn't About Working Less
- Apr 9, 2026Schizotypal Personality Disorder: What the System Gets Wrong (And What Social Workers Get Right)
- Apr 8, 2026AI Is Replacing Licensed Clinicians in Mental Health Triage — And Nobody Is Asking If Patients Are Safer
- Apr 7, 2026Your Doctor Asked About Your Housing and Food. Then Nothing Happened. Here's Why.
- Apr 6, 2026Screening Without Handoffs: Why CMS's SDOH Rollback Creates a Dangerous Gap for High-Risk Patients
- Apr 3, 2026Why AI Mental Health Apps Keep Failing You — And What Actually Works
- Apr 3, 2026Nobody's Calling Her a Narcissist: What Kristi Noem Teaches Us About Female Antagonistic Personality Patterns
- Apr 2, 2026How to Actually Use Your EAP (And Why Most Employees Don't)
- Apr 1, 2026Your VA Rating Isn't Safe Just Because You're Getting Better
- Mar 31, 2026The Personality Type That Never Asks for Help — And Why the System Doesn't Notice
- Mar 30, 2026When the Hospital Closes, the Neighborhood Pays: Urban Demand Concentration and the Hidden Equity Crisis
- Mar 30, 2026The IOTA Model Is Here — But Dialysis Centers Are Still Missing the Patients Who Need It Most
- Mar 27, 2026An Implantable Artificial Kidney Just Got FDA Breakthrough Status. Here's What It Actually Means for Patients.
- Mar 27, 2026Healthcare Worker Burnout Is Not Stress — It's Moral Injury in Real Time
- Mar 27, 2026The Urban-Rural Healthcare Divide: Why More Supply Doesn't Mean More Access
- Mar 27, 2026Financial Toxicity: The Chronic Illness Cost Nobody Talks About
- Mar 26, 2026SDOH Screening Without Referral Facilitation Is Performative Healthcare
- Mar 26, 2026Congress Is Funding Psychedelic Therapy for Veterans. Here's What Clinicians Need to Know.
- Mar 25, 2026An $8 Billion Industry That Can't Detect a Suicide — Why AI Mental Health Tools Are Failing
- Mar 24, 2026The Vulnerable Narcissist Is More Dangerous Than the Psychopath — And Science Agrees
- Mar 24, 2026Penalized for Healing: The VA Medication Rule That Punishes Veterans for Treating Their PTSD
- Mar 24, 2026Every Major Life Transition Is a Mental Health Event — And Most People White-Knuckle Through It
- Mar 24, 2026Complex PTSD: When Single-Trauma Frameworks Fail Your Healing
- Mar 20, 2026Narcissistic Mothers and Vulnerable Narcissism: When Your Kids Are Just Props | Taylor Frankie Paul & The Bachelorette
- Mar 18, 2026The Vulnerable Narcissist Nobody Warned You About
- Mar 18, 2026Narcissistic Abuse & Open Relationships: The Pattern Behind the Headlines
- Mar 17, 2026The $5 Billion Gap: Why AI Is Transforming Kidney Care for Providers but Not Patients
- Mar 16, 2026What to Expect in Your First Therapy Session
- Mar 16, 2026What Is Mental Wealth? And Why Maintenance Isn't Enough
- Mar 16, 2026What Does Evidence-Based Therapy Actually Mean?
- Mar 16, 2026Mental Health Therapy for Healthcare Workers and Transplant Patients: When Caregivers and Survivors Need Care
- Mar 16, 2026Mental Health Therapy for Healthcare Workers and Transplant Patients: When Caregivers and Survivors Need Care
- Mar 16, 2026The Vulnerable Narcissist: What Clinicians and Partners Need to Know
- Mar 16, 2026Signs You Need Therapy — Not Just Self-Help
- Mar 16, 2026The R.A.V.E.S. Framework Explained: How We Measure Real Therapeutic Progress
- Mar 16, 2026Mental Health for Entrepreneurs and High Achievers: When Success Becomes the Problem
- Mar 16, 2026Therapy for High-Functioning Anxiety: When Success Masks Suffering
- Mar 16, 2026What Does Evidence-Based Therapy Actually Mean?
- Mar 16, 2026Emotional Regulation Is a Skill, Not a Personality Trait
- Mar 16, 2026Burnout Is Not Just Tiredness — The Clinical Reality
- Jan 10, 2026If You Do Not Like the Term Narcissistic Abuse, Stop Engaging in the Behavior
- Jan 15, 2025Narcissistic Abuse: Frequently Asked Questions
- Jan 5, 2025The Dark Triad vs. The Light Triad: What the Research Actually Says
- Dec 28, 2024When They Won't Let Go: Hoovering, No Contact, and the Escalation from Narcissistic Abuse to Stalking
- Dec 20, 2024Announcing Vibe Check
- Dec 15, 2024Why People Miss Their Narcissist: The Withdrawal Paradox
- Dec 10, 2024Should You Hire a Narcissist? An Ethical Risk Assessment for Modern Businesses
- Nov 28, 2024Staying No Contact on Valentine's Day After Narcissistic Abuse
- Nov 20, 2024Mirroring: When Vodka on the Rocks Thinks It's a Martini
- Nov 15, 2024Understanding 'Narc Face': That Fleeting Moment of Feigned Confusion
- Nov 10, 2024The Narcissistic Abuse Cycle Experienced: From Belief to Awakening
- Nov 5, 2024Narcissistic Abuse and the Awakening: What the Moment of Clarity Actually Is
He writes the way a clinician actually talks — no wellness incense, no vibes.
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