iiinova — where your digital self keeps evolving

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 08/05/2025

Wondering why I enjoy working with people experiencing autism and ADHD, I thought it might be because I share their way of thinking, but I just now realized that I also enjoy working with people struggling with psychosis, intrusive thoughts, persistent worrying, which is less like me. Hmm.

130

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 06/03/2025

Swearing is an act of disinhibition that apparently gives us more strength, social connection, and pain tolerance. So when it feels necessary, let it happen! [Substituting nonsense words doesn’t have the same effect, maybe because you’re still inhibited.] www.washingtonpost.com/wellness/202...

020

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 05/03/2025

Essential to monetizing therapy models is a Name Brand ™️ ©️ made either of Two Words or a three or four letter acronym usually ending with “T”. Then it HAS to be valid, right? It has those initials that obviously stand for something systematic (robotic) and important (promoted).

010

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 15/02/2025

I’m preparing to give a talk on neurodiversity in the workplace, and on helping managers work with neurodivergence; right there are two different ways of thinking about people, in this age where talking about diversity is controversial. Here is another controversy that might come up: autism labels

Diagram of four different ways of describing the autism experience: “suffers from autism” “on the spectrum,” “person with autism,” or “autistic person.” #Autism #Neurodiversity #Neurodivergent

020

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 13/02/2025

For years I have labeled myself as a pushy meddlesome therapist, compared to “how was your week” therapists, but this week I was very delicate with people who were reactive to any suggestions. Maybe it’s more accurate to say that at times I lead people to the edge of their comfort zone.

110

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 08/02/2025

2) “realistic strategizing”: anxiety generates worst case scenarios: I help clients start from possible scenarios and think through how they would react, then what would happen next, continuing/extending this chain of possible actions and reactions until they get to the mundane part of the story.

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 08/02/2025

1). “Accurate observing”: anxiety-driven hypervigilance ironically misses seeing actual danger because of the constant visualization of imagined dangers; I encourage clients to ground themselves in current sensory information and picture options for action and reaction.

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 31/01/2025

Feeling stuck by always running late? Get unstuck by first examining, understanding: Is there conflict of cultural norms? Avoidance of leaving home or facing something? Untreated ADHD or OCD? Ingrained habits about how you get ready or judge time? Depression? Stress? Dissatisfaction? Resentment?

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 31/01/2025

True OCD, not just orderliness: what is uncomfortable yet effective is practicing not giving in to a compulsion or battling with an obsessive thought, but experiencing the discomfort and not letting it control your actions. In the short run it’s painful work, in the long run it’s empowering.

140

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 31/01/2025

I’ve neglected posting because many people follow me but don’t seem to interact with my posts; What would be an interesting topic related to mental health that you’d like to hear about in a quick 300 word tip or insight? I have given talks on dozens of issues… ask me!

251

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 31/01/2025

Two lessons here: 1) when you don’t see a way to eliminate a problem in your body, situation, or mind, you can start with a goal of reducing the time you spend preoccupied by the problem; and 2) read articles carefully, beyond the caption, to see what what the evidence itself reveals to you.

An article summary with a caption suggesting that keeping secrets is bad, while the actual results in the study show that it is the amount of time ruminating about the secrets that led to the negative health impact. #MentalHealth #Ruminating #Anxiety #Depression #CriticalThinking #Psychotherapy #Secrets #Trauma

130

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 16/01/2025

A view from a side lobby of my psychotherapy group practice space; hope you enjoy the butterflies as well as the little critters perched on the mirror frame.

A view of a psychotherapy office side lobby, looking through a mirror at some chairs with two wall hangings of butterflies; the mirror frame also has a tiny duck and googles eyes.

030

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 02/01/2025

My clients with anxiety or trauma have been stunned to realize, from other research like this, that FEELing vigilant for danger might make them less able to ACTUALLY notice dangers, as they are distracted by imagined threats from seeing details of their environment. www.psypost.org/eye-tracking...

psypost.org

Eye-tracking study suggests that people with social anxiety not only avoid looking at strangers but also their surroundings

A new study published in the journal PLOS One suggests that social anxiety is characterized by increased avoidance, rather than hypervigilance, during social situations.

120

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 19/12/2024

“Once some folks attach a scientific label to a being, they stop exploring who it is.” [Braiding Sweetgrass, p. 208]. This reminds me of the importance as a therapist of always letting my views of clients evolve, staying curious, trying new perspectives, especially as clients unpredictably change!

020

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 19/12/2024

This season can be a break from taking action [Some cold or cloudiness in the weather and mind can nudge us to linger at home], a time of seeking and providing comfort, warmth, closeness, mental engagement, giving, gratitude, and ingesting calories we might not burn off until spring. Enjoy. #hygge

In Iceland, books are exchanged as Christmas Eve presents, then you spend the rest of the night in bed reading them and eating chocolate. The tradition is part of a season called Jolabokaflod, or
'The Christmas Book Flood', because Iceland, which publishes more books per capita than any other country, sells most of its books between September and November due to people preparing for the upcoming holiday.

031

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 12/12/2024

In a session this morning, a client nudged me to challenge her even more. This was one of those times I find myself saying out loud between sessions, “WOW I love my work.”

030

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 05/12/2024

Based on the article below, I tried out the top performer in the study, Claude. AI models might be good at recognizing and replicating patterns in strings of words, but I don’t think there will be replacing psychotherapists or friends as true conversational partners… here, Claude will tell you:

This is a screenshot of a conversation with and AI model, Claude, as it explains why it can’t provide independent thought such as a critique, that it’s not a true conversational partner

010

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 04/12/2024

After 35 years of working with people who have previously been to other #Psychotherapists: in my large though admittedly skewed sample, I have found common errors leading #clients to: resist the process, fail to make progress, drop out, and resent the profession. See other posts for examples.

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 04/12/2024

When it comes to the effects of #trauma, #culture, #nutrition, and #genetics on #MentalHealth, we help clients when we help clients check in on those factors, and we chase clients away, or impede #therapeutic progress, when we impose those perspectives as THE lens for viewing their lives.

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 30/11/2024

News that surprised me with a curious smile: The #NFL trend of #journaling, part of a broader trend of #MentalHealth #wellness practices in professional sports. www.washingtonpost.com/sports/2024/... For those without #WaPo access (consider 32 cents/day supporting journalism): screenshots.

Story of the Buffalo Bills football player who started journaling to calm his mind and improve his mental health, with news that many football players do this across the league.

Image of football players, with text about different strategies and benefits of journaling

Story of one football player’s practic and benefits of journaling to clear their minds

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 28/11/2024

Trees can get our brains unstuck! A 2015 study showed that exposure to complex natural forms such as trees improved mood, by reducing activity in the the subgenual prefrontal cortex, which is active in rumination (depressive self-referencing thoughts). www.pnas.org/content/112/...

A photo of tree branches and leaves, with the caption “looking up at [and maybe touching or hearing!] trees/ calms the part of your brain that ruminates with self-doubt.”

143

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 24/11/2024

Interesting that this model doesn’t include anger or bargaining. I don’t have any universal model for typical #grief; I focus on the mental and emotional complications that people want help resolving, and there are a few that commonly come up (see below). What is your way of thinking about grief?

320

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 24/11/2024

Twice recently, new clients were rude, demanding, impatient at the front desk on their first visit (much more pleasant on their next check-in). Both clients revealed deprivation, stress, uncertainty, anxiety, isolation. Some struggling people wear a smiling mask; others show “problem” behavior.

091

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 23/11/2024

This is poignant for me after the recent end of my dog’s life after 16 years. We humans can’t help thinking about other things, but we can return to simply awareness and love for those who will sit (or play!) with us.

Image of a dog sitting on a bench with a person. The human is thinking about car, home, money, while the dog is thinking about the current scene of sitting with the person. Title/caption: “this is why dogs are happier.”

020

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 22/11/2024

Some of my clients scold themselves when they slip back into problematic behaviors or thinking; they can instead see it as natural that old patterns will sometimes pop up even during a new positive trend. Also posting this because I love dancing freely. #EcstaticDance #ForgiveYourself #SelfCare

Image of a little girl dancing on a beach, overlaid with a caption “if you stumble, make it part of the dance.“

020

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 21/11/2024

[Focus on] Movement from a starting line, not distance from a finish line.

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 20/11/2024

Adding to the list: Anhedonia, avolition, life of confidence, lack of skills, or a mismatch between what’s important to them and what others deem as important, which can lead either to rebellious recalcitrance or to being paralyzed by the shame of not living up to “should” statements.

020

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 20/11/2024

So glad to hear this; so often the impact hinges on interventions captured by precise choice of language that helped the client anchor and remember what works, and LLM AI would homogenize that into fluff. Even if it was trained only on my own notes, no: useful wording is specific to each client.

020

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 20/11/2024

It pays to try this even clients you might think wouldn’t be interested; a gruff Appalachian client recently found value in putting on a yoga instruction video when he is stuck in dissociative depersonalization, I think grounding him in his body and the present, and letting himself be guided safely

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 20/11/2024

This is why I obsessively read my notes before the next session, don’t trust my memory. Still, what occasionally stuns me is something similar, being surprised at HOW clients remember my advice, which STRATEGY they found useful, And which CLIENTS took some small comment and really ran with it

010

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 19/11/2024

Slogan invented in a session just now: “the calm middle ground between hope and doubt (between overexcited wishfulness and cynical dread in this case) is strategizing.” —> Stop the swing between “this will be great” and “this will fail” by facing the risks and figuring out how it can turn out OK.

000

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 18/11/2024

I came across this while preparing to facilitate a group for dementia caregivers. I had to follow some of this myself when my mother experienced months of delirium, which resembles some dementia symptoms and adds hallucination, disorientation, and delusions. ...whew. At least delirium can improve.

100

Jim Foley, Psychotherapist @mentalhealthsky.bsky.social · 18/11/2024

I once was giving a talk on childhood anxiety and school avoidance to some parents, and although this was a group of Amish parents living far from the sea, this was the quote that seemed to strike a chord with the most people. Then they talked of facing their own obsessive worrying…

000

Reposted by Jim Foley, Psychotherapist

Jim Foley @jimfoley.bsky.social · 14/11/2024

I’ve just explored the psychotherapy realm on Bluesky and I feel alone in developing #psychotherapy interventions originating in the client’s agenda, mindset, and history rather than imposing one of with the many models and protocols I’ve been trained in. #mentalhealth

011

Reposted by Jim Foley, Psychotherapist

Jim Foley @jimfoley.bsky.social · 14/11/2024

The #paychotherapy clients who tell me that I should write a book, don’t realize that I write a fresh book for each client; the slogans, insights, and strategies they find useful are my responses to their personal histories, cultural influences, patterns of thinking, emotional and relational styles

021