Uncategorized – LIBERTY PSYCHOLOGICAL ASSOCIATION

Prompt professional or emergency evaluation may be appropriate for worsening Psychosis symptoms:

If someone is experiencing rapidly worsening psychosis, dangerous behavior, inability to care for themselves, or thoughts of harming themselves or someone else, prompt professional or emergency evaluation is appropriate.

A mental health emergency is a situation in which a person’s psychological or behavioral state has deteriorated to the point that there may be an immediate risk of harm, severe impairment, or inability to care for basic needs. The priority is safety, stabilization, and appropriate professional intervention, not diagnosing the person in the moment.

Signs that may indicate an emergency:

Imminent suicide or self-harm risk

Expressing an intention or plan to die or seriously harm themselves

Accessing or preparing means for suicide

A recent suicide attempt

Saying others would be better off without them

Giving away possessions or making final arrangements

Risk of violence

Specific threats toward another person

Severe agitation or escalating aggression

Access to weapons combined with threats or impaired judgment

Inability to respond to reasonable attempts at de-escalation

Severe psychosis

Extreme disorganization or inability to communicate coherently

Hallucinations or delusions accompanied by dangerous behavior

Severe paranoia resulting in attempts to escape, attack, or defend against perceived threats

Profound loss of contact with consensual reality

Importantly, having hallucinations or unusual beliefs alone does not automatically mean someone is dangerous or experiencing an emergency. Risk should be assessed based on behavior, intent, judgment, and circumstances.

Severe mania or behavioral dysregulation

Extreme agitation or impulsivity

Little or no sleep for an extended period

Grandiosity accompanied by dangerous behavior

Reckless spending, driving, sexual behavior, or other high risk actions

Severe impairment in judgment

Severe inability to care for oneself

Not eating or drinking adequately

Extreme confusion or disorientation

Wandering or becoming lost

Being unable to obtain essential medication or shelter

Profound deterioration in functioning

Altered consciousness or unusual behavior with a possible medical cause A sudden behavioral change may result from delirium, intoxication/withdrawal, medication effects, neurological illness, infection, metabolic problems, or other medical conditions. A first episode of severe confusion or bizarre behavior therefore warrants medical assessment rather than assuming it is psychiatric: consult with a Neurologist/Psychiatrist.

How to respond effectively

Stay calm.

Use a low, slow, non-confrontational voice. Avoid arguing, threatening, crowding, or attempting to “prove” that the person’s perceptions are wrong.

Establish immediate safety.

Ask directly when appropriate:

“Are you thinking about hurting yourself or someone else?”

Reduce stimulation:

Move to a quieter environment when possible. Reduce unnecessary people, noise, and confrontation.

Listen without validating potentially dangerous beliefs.

You may validate the emotion without confirming the belief:

“That sounds frightening. I can see that you’re very concerned. Let’s focus on keeping you safe.”

Rather than:

“Yes, those people really are following you.”

Do not leave someone alone when there is imminent danger.

If safe to do so, remain with the person while emergency assistance is obtained.

Involve appropriate professionals.

Depending on severity, this might include a mental health crisis team, clinician, mobile crisis service, emergency department, or emergency medical services.

Treat medical emergencies as medical emergencies.

If there is overdose, serious injury, unconsciousness, severe confusion, seizure, difficulty breathing, or another potentially life threatening condition, CALL 911.

In the United States:

For an immediate life threatening emergency, call 911 or go to the nearest emergency department.

For suicide, self-harm, or emotional crisis support, 988 provides the Suicide & Crisis Lifeline. The person does not necessarily need to be suicidal to contact 988; it may also be used for significant emotional or behavioral crises.

A possible useful mental health principle:

A mental health emergency is best conceptualized through risk, impairment, urgency, rather than simply through the presence of a psychiatric symptom:

What is happening?

How impaired is the person?

Is anyone in immediate danger?

Could there be a medical/substance related cause?

Shervan K Shahhian

What to Do if Someone Has a Psychotic Episode: Family Support Options

What to Do if Someone Has a Psychotic Episode: Family Support Options

https://mentalhealthhotline.org/helping-someone/psychosis/

Helping someone with psychosis starts with staying calm, listening without judgment and letting them lead the pace. Don’t argue with hallucinations or delusions, but don’t pretend to share them either; focus on how the person feels and on keeping them safe. You can’t force treatment, but you can stay connected and help them find support. If you’re not sure where to start, call the Mental Health Hotline at

866-903-3787 to get connected with resources for your loved one or for yourself.

AI-Induced Psychosis is not yet a formally established diagnosis:

AI-induced psychosis is not yet a formally established diagnosis. The term is increasingly used to describe situations in which interaction with an AI system may contribute to, amplify, or reinforce psychotic like thinking or severe loss of reality testing, particularly in vulnerable individuals.

How it may happen:

AI systems may potentially become part of a person’s belief system in several ways:

Reinforcement of unusual beliefs: An AI may inadvertently validate a user’s interpretation rather than challenge it.
Anthropomorphism: The person may begin experiencing the AI as a conscious being, spiritual entity, persecutor, romantic partner, or special guide.
Delusional elaboration: Extended conversations may provide increasingly elaborate explanations for coincidences, surveillance, hidden messages, or supernatural experiences.
Confirmation loops: The person asks increasingly leading questions and receives responses that appear to confirm the original premise.
Sleep deprivation and excessive use: Prolonged late night interaction may worsen vulnerability to paranoia, mania, dissociation, and psychosis.
Mania or psychosis: Someone already developing a manic or psychotic episode may incorporate AI generated material into grandiose, paranoid, religious, or persecutory beliefs.

An important distinction

AI generally may not be described as literally “causing schizophrenia.” A more clinically defensible formulation could be:

AI interaction may act as a precipitating, amplifying, or maintaining factor in psychotic symptoms in susceptible individuals.

The underlying vulnerability may involve psychiatric illness, sleep deprivation, substance use, trauma, “neurological conditions: consult with a Neurologist”, severe stress, or other factors.

A particularly important phenomenon: the AI reality validation loop

One concerning pattern looks like this:

Unusual experience…interpretation...AI confirmation…increased conviction…additional searching…more “evidence”…stronger conviction

For example, someone might say:

“I think the government is communicating with me through coincidences.”

A poorly calibrated AI might respond in a way that treats the premise as established fact. The user may be then interpret the AI’s response as independent confirmation, even though the AI is actually generating language rather than independently verifying the claim.

This could be why epistemic humility and reality testing are especially important when discussing paranoia, voices, supernatural experiences, UAPs, telepathy, or other anomalous phenomena.

Clinical perspective

A clinician should neither automatically dismiss an unusual experience nor automatically affirm its proposed explanation, right away.

A useful approach could be:

Validate the experience without automatically validating the interpretation.

For example:

“I can see that this experience feels very real and significant to you. Let’s examine what you experienced, what explanations are possible, and what evidence would distinguish among them.”

That approach is compatible with both mental health consulting and responsible exploration of anomalous experiences. It preserves curiosity without sacrificing reality testing.

Possible warning signs:

AI interaction may become particularly concerning when someone develops:

increasing certainty about an implausible belief
severe paranoia or perceived persecution
belief that AI is secretly communicating with them
belief that AI has supernatural powers or consciousness specifically directed toward them
escalating grandiosity or claims of a special mission
hearing/seeing things associated with AI-generated interpretations
markedly reduced need for sleep
disorganized thinking or behavior
withdrawal from ordinary relationships and responsibilities

The emerging concept of AI induced or AI amplified psychosis is therefore best understood as a clinical and technological phenomenon under investigation, rather than a new established psychotic disorder.

Shervan K Shahhian

Parapsychology, the Informational Field Hypothesis:

In Parapsychology, the Informational Field Hypothesis is the idea that information may exist in a nonlocal field that extends beyond the individual mind and ordinary sensory channels. According to this concept, consciousness may be able to access information that is not limited by distance, time, or conventional physical communication.

This hypothesis has been proposed to explain phenomena reported in parapsychological research, such as:

Telepathy: the apparent transfer of thoughts or feelings between individuals without known sensory means.

Clairvoyance: obtaining information about distant objects, places, or events.

Precognition: awareness of future events before they occur.

Remote Viewing: describing locations or targets beyond ordinary perception.

Psi experiences: spontaneous intuitive impressions, dreams, or impressions that seem to contain unknown information.

Several theories have attempted to describe such an informational field:

Parapsychologists sometimes describe this field as a type of nonlocal information system, where consciousness acts more like a receiver, filter, or participant rather than the sole creator of experience.

From the perspective of mainstream science, however, an informational field extending beyond known physical mechanisms remains hypothetical and may not been conclusively demonstrated. Research into psi phenomena continues, but there is currently no broad scientific consensus that such a field exists.

The idea remains an intriguing bridge between psychology, consciousness studies, physics inspired speculation, and parapsychology, inviting questions such as:

Is consciousness entirely produced by the mind?

Can information exist independently of individual minds?

Are all minds interconnected in ways not yet understood?

These questions continue to be explored in parapsychology, psychical research, and consciousness studies, although definitive answers have not yet been established.

Shervan K Shahhian

Free Floating Anxiety (FFA), refers to a persistent, generalized feeling of fear, apprehension, nervousness:

Free floating anxiety refers to a persistent, generalized feeling of fear, apprehension, nervousness, or uneasiness that does not seem to be tied to one specific situation or identifiable threat.

Instead of thinking, “I am anxious because of this particular event,” a person may experience a more diffuse sense that something is wrong or something bad might happen, even when there is no obvious immediate danger.

Common features

A person experiencing free floating anxiety may have:

Persistent worry or apprehension
Feeling “on edge” or unable to relax
Restlessness or irritability
Racing or excessive thoughts
Difficulty concentrating
Muscle tension
Fatigue
Sleep difficulties
Increased heart rate or feeling “keyed up”
A vague sense of dread or impending trouble

Example

Someone might say:

“I don’t know what I’m worried about. Nothing specific is happening, but I feel anxious all day, as if something bad is about to happen.”

That is characteristic of diffuse or free floating anxiety.

Relationship to Generalized Anxiety Disorder

The term free floating anxiety is commonly associated with generalized anxiety, particularly the type of persistent anxiety seen in Generalized Anxiety Disorder (GAD).

GAD involves excessive anxiety and worry about multiple areas of life, occurring more days than not for at least six months, along with associated symptoms such as restlessness, fatigue, concentration problems, irritability, muscle tension, or sleep disturbance.

What may contribute to it?

Free floating anxiety may arise from many factors, including:

Psychological

Chronic stress
Unresolved emotional conflicts
Trauma related hyperarousal
Excessive worry patterns
Perfectionism or intolerance of uncertainty

Biological

Chronic activation of the stress response
Sleep deprivation
Certain medications or substances: “Consult with a Medical Doctor.”
Excessive caffeine or other stimulants: “Consult with a Medical Doctor.”
Some medical conditions: “Consult with a Medical Doctor.”

Environmental

Ongoing interpersonal stress
Financial or occupational uncertainty
Lack of safety or stability
Major life changes

A useful clinical distinction

Free floating anxiety is different from situational anxiety:

Free floating anxiety	Situational anxiety
Diffuse and difficult to identify	Connected to a specific situation
May persist much of the day	Usually occurs around the trigger
“Something feels wrong.”	“I’m anxious because I have to give a speech.”
Multiple worries may shift from one subject to another	Usually focused on one identifiable concern

In clinical work, it may be useful to explore what the anxiety is doing rather than only what it is about, for example, whether it reflects chronic hyperarousal, excessive worry, avoidance, unresolved trauma, or difficulty tolerating uncertainty.

Shervan K Shahhian

Tobacco Use Disorder (TUD) is a pattern of tobacco use that leads to clinically significant impairment,…

        "Please, Consult with a Medical Doctor"

Tobacco Use Disorder (TUD) is a pattern of tobacco use that leads to clinically significant impairment or distress, despite the person experiencing negative consequences or wanting to cut down or quit.

Tobacco Use Disorder (TUD) is a Substance Related and Addictive Disorder. The diagnosis may apply to dependence on nicotine from cigarettes, cigars, smokeless tobacco, or other tobacco products.

Why tobacco is addictive

“Please, Consult with a Medical Doctor”

The primary addictive substance in tobacco is nicotine. Nicotine activates the mind’s reward system, particularly pathways involving dopamine. With repeated use, the mind adapts to nicotine, producing tolerance and dependence.

When nicotine levels fall, a person may experience withdrawal symptoms such as:

“Please, Consult with a Medical Doctor”

Irritability or anger

Anxiety or restlessness

Difficulty concentrating

Depressed or dysphoric mood

Increased appetite

Insomnia or disturbed sleep

Strong cravings for tobacco

Tobacco Use Disorder involves a problematic pattern of tobacco use. Examples of diagnostic features include:

“Please, Consult with a Medical Doctor”

Using tobacco in larger amounts or for longer than intended.

Repeated unsuccessful efforts to cut down or quit.

Spending substantial time obtaining or using tobacco.

Experiencing strong cravings.

Continued use despite physical or psychological problems caused or worsened by tobacco.

Giving up or reducing important activities because of tobacco use.

Developing tolerance.

Experiencing tobacco withdrawal when use is reduced or stopped.

Treatment

“Please, Consult with a Medical Doctor”

Tobacco Use Disorder is treatable, and combining behavioral support with medication generally provides the strongest approach.

Common interventions include:

“Please, Consult with a Medical Doctor”

Motivational interviewing (MI) to explore ambivalence about quitting.

Cognitive behavioral therapy (CBT) to identify triggers and develop coping strategies.

Behavioral strategies for managing cravings and preventing relapse.

Nicotine replacement therapy (NRT) such as patches, gum, or lozenges:”Please, Consult with a Medical Doctor”

Prescription medications such as varenicline or bupropion, when clinically appropriate:”Please, Consult with a Medical Doctor”

Quitlines, support groups, and structured tobacco cessation programs.

An important distinction

“Please, Consult with a Medical Doctor”

Nicotine dependence describes the physiological and behavioral dependence on nicotine, while Tobacco Use Disorder is a framework for determining whether tobacco use has become sufficiently problematic to constitute a mental health/substance use disorder.

A person may be nicotine dependent without necessarily experiencing severe functional impairment, so assessment should consider the entire pattern of use, consequences, withdrawal, attempts to quit, and level of impairment.

Shervan K Shahhian

Emotional Balance is the ability to experience, understand, and manage your emotions,…

Emotional Balance is the ability to experience, understand, and manage your emotions without allowing any single emotion to completely control your thoughts, behavior, or decisions.

It may not mean being happy all the time or suppressing difficult emotions. Instead, it means being able to move through emotions while maintaining perspective and functioning.

The key elements of emotional balance:

Emotional awareness: Recognizing what you are feeling and identifying the emotion accurately: “I’m frustrated,” “I’m anxious,” “I’m disappointed.”

Emotional regulation: Being able to calm, tolerate, or modulate intense emotions rather than immediately reacting to them.

Acceptance: Allowing uncomfortable feelings to exist without judging yourself for having them.

Perspective: Remembering that emotions are signals, not necessarily facts. Feeling rejected, for example, may not automatically mean that you have actually been rejected.

Healthy expression: Communicating emotions appropriately rather than bottling them up or expressing them destructively.

Resilience: Recovering your emotional equilibrium after stress, disappointment, conflict, or loss.

Balanced decision making: Giving emotions a voice without allowing them to make every decision. Ideally, emotion and reason work together.

A simple model

Notice, Pause…Understand…Regulate…Choose…Act

For example:

“I’m extremely angry. Let me pause before responding. What triggered this? What am I actually feeling? What response would be consistent with my values?”

That brief pause may create a space between feeling an emotion and acting on it.

Emotional balance may not be emotional suppression

Emotional suppression	Emotional balance
“I shouldn’t feel angry.”	“I’m angry, and I can understand why.”
Pushes emotions away	Allows emotions to be experienced
May lead to buildup	Processes emotions gradually
Reacts automatically later	Creates room for choice
Seeks to eliminate emotions	Learns to manage emotions

A useful definition:

Emotional balance may be the capacity to feel deeply without being overwhelmed, to acknowledge difficult emotions without being controlled by them, and to respond to life with flexibility, perspective, and self-awareness.

Shervan K Shahhian

Transference and Countertransference are important concepts in the mental health professions:

Transference and Countertransference are important concepts in the mental health professions that describe how feelings, expectations, and relationship patterns may become activated between a client and mental health professional.

Transference

Transference may occur when a client unconsciously transfers feelings, expectations, or relationship patterns from important people or past experiences onto the therapist.

For example, a client who had a highly critical parent may begin to experience the therapist as critical or judgmental, even when the therapist has not behaved that way.

Transference may

involve:

Positive feelings: idealization, admiration, strong attachment, or dependency.
Negative feelings: anger, distrust, fear, resentment, or feeling rejected.
Relationship expectations: expecting the therapist to abandon, control, rescue, criticize, or disappoint them.
Past relational patterns: repeating familiar interpersonal dynamics within therapy.

Importantly, transference may not necessarily pathological. It may provide valuable information about how a client experiences relationships and could become an important focus of treatment.

Countertransference

Countertransference refers to the therapist’s emotional reactions toward the client.

Originally, the term was often understood as the therapist’s unconscious feelings arising from the therapist’s own unresolved issues. Modern psychotherapy may use the concept more broadly to include the therapist’s emotional, cognitive, and behavioral responses to the client and the therapeutic relationship.

For example, a therapist might notice:

An unusually strong desire to rescue a client.
Feeling excessively protective toward the client.
Feeling unusually irritated or angry.
Feeling responsible for the client’s life outside therapy.
Wanting to give the client special treatment.
Feeling unusually helpless, bored, anxious, or rejected.

These reactions may not automatically mean the therapist is doing something wrong. They could provide clinical information, but they need to be recognized and managed appropriately.

How they interact

A useful way to think about the two concepts is:

Client’s past experiences…Transference…Therapist

Therapist’s emotional response…Countertransference…Client

For example:

A client who has experienced abandonment becomes extremely fearful that the therapist will leave. The therapist notices a strong urge to reassure and “save” the client. The client’s fear may represent transference, while the therapist’s rescuing impulse may represent countertransference.

The therapist’s task may not simply to suppress these reactions, but to recognize them, reflect on them, maintain professional boundaries, and determine whether they contain clinically useful information.

Why they matter clinically

When handled appropriately, transference and countertransference may help therapists understand:

The client’s interpersonal patterns
Attachment expectations
Unresolved emotional conflicts
Triggers and vulnerabilities
The therapeutic relationship itself
Potential boundary problems

Professional supervision and consultation may be particularly important when countertransference is intense or persistent.

A key ethical principle

A therapist may not act out countertransference. For example, feeling protective of a client may not justify becoming personally involved, giving inappropriate favors, violating boundaries, or attempting to become the client’s rescuer.

Instead, the therapist may ask:

“What am I feeling, why might I be feeling it, and what does this tell me about the therapeutic relationship?”

That reflective stance turns a potentially problematic reaction into potentially useful clinical information.

In short:

Transference: what the client brings from previous relationships into the therapeutic relationship.

Countertransference: what the therapist experiences emotionally in response to the client and the therapeutic relationship.

Both require careful self-awareness, boundaries, ethical practice, and when appropriate clinical supervision.

Shervan K Shahhian

Maintaining Appropriate Boundaries, Confidentiality, and Professional Ethics is Fundamental to Safe and Effective Mental Health Practice:

Maintaining appropriate boundaries, confidentiality, and professional ethics is fundamental to safe and effective mental health practice. These principles protect clients, support therapeutic trust, and help clinicians maintain professional integrity.

1. Appropriate Professional Boundaries

Professional boundaries define the limits of the therapeutic relationship. The clinician should maintain a relationship that is professional, respectful, and focused on the client’s therapeutic needs.

Important boundaries include:

Avoiding dual relationships that could impair professional judgment.
Avoiding romantic, sexual, or exploitative relationships with clients.
Maintaining appropriate physical and emotional boundaries.
Being careful about self-disclosure and ensuring that it serves a legitimate therapeutic purpose.
Avoiding financial, social, or personal arrangements that could create conflicts of interest.
Maintaining appropriate boundaries in electronic communication and social media.
Recognizing and managing transference and countertransference when they affect the therapeutic relationship.

Boundaries may not be viewed as creating emotional distance. Rather, they provide a safe and predictable framework for therapy.

2. Confidentiality and Privacy

Confidentiality means protecting information that clients disclose during treatment. Clients should generally understand that what they share will be kept private and used only for legitimate professional purposes.

Mental health professionals should:

Protect clinical records and personal information.
Discuss cases privately and only with appropriate individuals.
Use secure methods of communication and record storage.
Obtain appropriate authorization before releasing protected information.
Explain the limits of confidentiality at the beginning of treatment.
Be particularly careful when discussing cases for consultation, supervision, education, or research.

Confidentiality is important because clients are more likely to be honest and engaged in treatment when they feel psychologically safe.

3. Limits of Confidentiality

Confidentiality is not absolute. Depending on applicable law, professional regulations, and the circumstances, disclosure may be permitted or required when there is a serious safety concern, suspected abuse or neglect, certain legal requirements, or other legally recognized exceptions.

For example, clinicians may have obligations involving:

Serious threats of harm to others
Imminent risk of suicide or serious self-harm
Suspected abuse or neglect of children or vulnerable persons or elderly
Court orders or other legally mandated disclosures

The exact requirements vary by jurisdiction and professional license, so clinicians should know the laws and regulations governing their practice.

4. Professional Ethics

Ethical practice involves more than simply following laws. Mental health professionals should strive to act in ways that promote beneficence, nonmaleficence, autonomy, justice, fidelity, and respect for human dignity.

This includes:

Practicing within one’s competence and scope of practice.
Using appropriate assessment and evidence informed interventions.
Obtaining informed consent.
Respecting client autonomy and decision making.
Avoiding discrimination and exploitation.
Maintaining accurate clinical documentation.
Recognizing conflicts of interest.
Seeking consultation or supervision when needed.
Continuing professional education.
Being honest about qualifications, experience, and limitations.

5. Cultural and Individual Respect

Ethical boundaries also require sensitivity to the client’s culture, values, beliefs, identity, family circumstances, and worldview. Clinicians should avoid imposing their own beliefs on clients while still maintaining appropriate professional standards.

6. When Boundaries Become Difficult

Boundary issues may arise when a clinician develops unusually strong feelings toward a client, becomes overly involved in a client’s personal life, receives inappropriate gifts, communicates excessively outside sessions, or begins making decisions based on personal rather than therapeutic considerations.

A useful question is:

“Is this action primarily serving the client’s therapeutic interests, or is it serving my personal interests or needs?”

When uncertain, consultation, supervision, ethical codes, and applicable laws may help guide decision making.

In summary

Boundaries protect the therapeutic relationship. Confidentiality protects the client’s privacy. Professional ethics protect the client’s dignity, autonomy, safety, and well being.

Together, they establish the foundation for a therapeutic relationship based on trust, respect, accountability, and professional integrity.

Shervan K Shahhian