Episode 29: Writing the Book on Personality Disorders with Dr. John Oldham

You can use code MENN2023 for 50% off your New Personality Self Portrait (NPSP25) personality test! Visit npsp25.com to learn more. 

This episode of the Menninger Clinic’s Mind Dive podcast features the psychiatrist who wrote the book on personality and personality disorders. Dr. John Oldham is co-author of, “The New Personality Self-Portrait: Why You Think, Work, Love and Act the Way You Do,” the book is largely credited for spearheading the DSM-5 alternative model for personality disorders. 

Dive in with hosts Dr. Kerry Horrell and Dr. Bob Boland and explore the factors that make personality as unique as a fingerprint and learn if the alternative model of understanding personality will overtake the DSM-4 categorical model. Also, Dr. Oldham reacts to the individual NPSP25 test results of Dr. Boland and Dr. Horrell. 

John M. Oldham, M.D., M.S., currently serves as Distinguished Emeritus Professor in the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine. He previously served as senior vice president and chief of staff at the Menninger Clinic, president of the American Psychiatric Association (APA) and president of The American College of Psychiatrists. Dr. Oldham has also recently served as the APA’s co-chair of the Work Group on Personality and Personality Disorders for the most recent edition of the DSM-5.  

“I like to explain the personality through a blood pressure metaphor,” said Dr. Oldham. “In a dimensional sense, you have to have blood pressure or you’re not human or alive. You have to have a personality or you’re not human or alive. However, have too much or too little of a necessary thing, and you’re going to have a real problem.”  

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Visit www.menningerclinic.org to learn more about The Menninger Clinic’s research and leadership role in mental health. 

Listen to Episode 28: Making the Case for Psychotherapy with Dr. Jo

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Visit The Menninger Clinic website to learn more about The Menninger Clinic’s research and leadership role in mental health.

Transcript

00:02

Welcome to the Mind Dive Podcast brought to you by the Menninger Clinic, a national leader in mental health care. We're your hosts, Dr. Bob Boland, and Dr. Kerry Horrell. Twice monthly, we dive into mental health topics that fascinate us as clinical professionals, and we explore those unexpected dilemmas that arise while treating patients. Join us for all of this, plus the latest research and perspectives from the minds of distinguished colleagues near and far. Let's dive in.

00:42

We're very lucky today we have Dr. John Oldham. Dr. John Oldham, among the many things he's done, this is obviously modest because this is a very short intro, but I'll read it does not do justice. Dr. John Oldham is a psychiatrist, distinguished emeritus professor at Baylor College of Medicine. He formerly served as the president of the American Psychiatric Association. And he was the senior VP and the Chief of Staff at the Menninger Clinic. 

01:07

He was your predecessor.

01:08

He was indeed. Big, big shoes that I'm not filling, but there you go. So, welcome very much. Welcome. 

01:16

Thanks, Bob. Thanks, Kerry. It's great to join you. 

01:19

All right. I would just like to say at the start of this, I definitely, especially when I was an intern, I used to totally brag to my grad school cohort mates, that I was like, the Dr. John Oldham is the chief of staff at the hospital I work at, you know, the man who wrote the chapter on personality disorders. 

01:37

Come on. 

01:37

I was, it was real bragging rights for me. Yeah, I mean, so like, we're going to talk all about that today, or at least as much as we can. But let's just start with a little bit about you. I mean, so you've devoted your life right, the studying, treating personality disorders, how did you develop an interest in that will be a long story.

01:55

The brief version, I've just always been interested in human behavior and how to understand it, and what the medical schools are for that reason. And that's how I drifted into psychiatry. And then at the my residency at Columbia, in New York, and I was very lucky, because in those days, what you generally did was your residency training. But you could also do psychoanalytic training. Yep. And I was fortunate because my, one of my supervisors, and my psychoanalytic training was a man named Otto Kernberg.

02:24

We know him. 

02:25

Yeah, I think most people know him. He's a pioneer, and rather than one of the greats in terms of personality, understanding, and so I was really lucky to have his hand holding, as I tried to learn to take care of patients, and particularly patients with personality disorders. So a couple of years later, Otto hired me, and I came and worked for him. So he was my boss. And I was at New York Hospital Westchester Division, where he was medical director. So that was wonderful experience for me. I was there on the Cornell faculty working with wonderful colleagues. And with my good friend John Clarkin, the two of us actually started Otto Kernberg's first ever research project on borderline personality disorder. 

03:11

That sort of got me launched and hooked. And from then on, really, it's been a central theme of interest. For my career, I've been really fortunate to be involved, both organizationally institutionally, but also in my clinical work and my clinical practice. 

03:15

And we're gonna come more to this. But you are, you are the co chair on the DSM Task Force for personality disorders, you were one of the major spearheads of the alternative model. But before we get into that, if we were to do some definitions, I think this is so important, because as a psychologist, as a clinician, myself, when I talk to patients about personality functioning, it often lands as a sense of like, "Ooh, there's something wrong with my personality? Now, the disorder is just me?" That is painful. And I think it really requires a delicate explanation. And so I wonder if you could kind of define what personality is particularly and how we use it clinically, and what you sort of mean by a personality disorder? 

04:13

Yeah, sure. critical question. But generally, an important point. That's right in the middle of your question is, people need to not be afraid to try to think about personality, their own friends and their family and other people. And we're gonna get back to that. But a personality itself is generally understood in a dimensional way. It's a mix of personality traits, and they range from minimally present to extreme, and one has a sort of unique personality fingerprint. That's often the way I describe it. So no, fingerprints, no two personalities are identical. But many people share many particular traits that are prominent, and others, share other traits.

04:59

Traits that are prominent... It's a, an essence defining feature of who we are as humans and how we behave. And it emerges as we develop during childhood and early adulthood that stabilizes actually by early adulthood. And anybody's personality is a combination of genetic predisposition, there is a temperament component, or with some of it, and then as you grow up your life experiences, shape and mold your particular individual personality fingerprint.

05:35

And so when you think about that, in regard to a disorder, what what does that mean that someone has a disorder of their personality? Well, that'll get us into talking about the alternative model. But let me before doing that, just say that I often say that when I used to give family workshops at Menninger, I would point out that you can think about personality using a blood pressure model. And say, dimensional sense. So yeah, gotta have blood pressure, or you're not human, you're not alive, you're gonna have a personality, or you're not human, and you're not alive, but too much, or maybe too little of a necessary thing, and have a problem. 

06:11

Hmm, interesting. Yeah. I'm just gonna spoiler alert here now, some of our chuckles are that, at the end of this, we're going to talk about Bob and mine. Yeah, we did our personality tests. More than others, people can look forward to that as

06:26

Yeah, I mean, is it fair to say because, like, one of the ways that it was explained to me early on, I mean, really, by behaviorists was that they, they defined precisely kind of like just a set of behaviors that seem predictable of a person, like we all have our kind of set of things, you know, ways that we react to different situations that are, you know, reasonably predictable, is that fair? To none of that's absolutely fair. And that's been studied extensively. 

06:52

In the world of psychology and Kerry, I'm sure you know a lot about this, studying personality and normal trait ranges, has been very common. So there's something well known called the Five-factor model, which are personality trait domains. You're either have a lot of or a little of, but that pretty much cover the waterfront, in terms of behavior of the human species. And those five factors they call neuroticism, extraversion, openness, agreeableness, and conscientiousness. And there are a whole set of factors that go into more detail, I always like to use a kind of revision of that and change the word neuroticism to emotional stability. 

07:39

Good because neuroticism has a certain stuff and

07:44

"Neuroticism" makes you worry. 

07:45

And just to clarify for people listening, I so basically, you're just saying is that they kind of took the range of, you know, how do you break down personality to different sort of clusters and what behaviors are and they came up with, like five. And I've, there's, I guess there's other systems that do it differently. But that seems like a pretty good one, when you look at it, when you try to come up with something that doesn't fit in that box. It's kind of hard, right? If we had more time, we could talk about lots of others that have been done, which are actually dimensional system means that you've got so much of a particular tray, so much of another tray, and we pretty much have a composite picture of what the traits are that will cover most people. And so like to take an example, like you mentioned, like extraversion, I guess versus introversion, and we all probably know someone, where more or less we fall on that scale.

08:36

Yeah, yeah, I often I often joke that I'm pathologically extroverted. I'm like 100 out of 100?

08:43

Well, we'll get back to.

08:47

Yeah, I will say to Dr. Oldham, one of the things that I've just really admired about your work is that you have tended to, I think, try to take some of the stigma, and some of the critical nature of talking about personalities in the field of psychiatry kind of out of the mix, and understanding personality or in just regard to like, like you've said, it is a part of being human. And ultimately, again, that seems like that is really trickled into the your work in developing the alternative model. And I wonder if you would like to speak a little bit to, again, I know the time is limited, but what it was like, what what you were thinking in helping develop this model and ultimately, like, what is this quote unquote, alternative model? Well, we chaired the workgroup on personality and personality disorders. The chair was Andy Skodol, a good friend and colleague, and we had a really good crew of research and political psychiatrists and psychologists on the team. And our mandate from the APA was to develop a dimensional model because the recognition has been present for years that the categorical system that's familiar to us that's in the Assam four is not really very accurate or helpful when it comes to personality.

09:59

If for people who may not know that's that's basically picking from a menu of symptoms, and if you've got enough, you've got the disorder. Right. And, you know, that's something that was a good step forward in DSM-3, I was involved that far back in terms of the development of criteria defined the categories of personality disorders using a medical model. And we're used to trying to figure out what's wrong? And why is it wrong? comes later? But how can we describe it? So I guess I'm three was really the first elaborate effort to develop descriptive phenomenology, how can we define develop criteria that define these personality disorders using a medical model, and that helped us move the field forward, even though it was somewhat artificial, because they really aren't discreet boundaries between one thing and another, if you think about a good way to think about dimensional systems versus categorical systems, dimensional systems would be things like height, and weight, there is no break along the curve, or along the spectrum. Whereas categorical systems could be something like being male, or being female, or being pregnant, that is something definable, discrete, and different from other things. So personality clearly fits in the former category, the dimensional system, but we've learned about it using the categorical medical framework. But the medical framework focuses on pathology, whereas dimensional personality studies go back to that five factor model that we just talked about, which has been studied in normal populations, often college populations. So what I've tried to do, and we'll get to that in a minute, is to kind of put the two together using that sort of blood pressure concept. And helping us understand that you can have a particular personality trait that can work very well for you. 

12:03

But if it turns out to get too strong, or if it's too extreme, it starts to become a problem and starts to backfire, and starts to get in the way. That doesn't mean necessarily, that even if one or two of your personality traits, let's say if you have a lot of self confidence, but so much that people call you a narcissist, all the diagnosis, but you may be getting beyond what's really going to work well for you, doesn't mean you've got a personality disorder, and you got a lot of other traits, as well as that one. But just conscientiousness or maybe others like sensitivity, or adventurousness, there are a whole range of personality traits that we'll look at in a minute. And there will not be anywhere near in the treble range. So that's a way to think about it. Each of us has a mix of these traits, more of some less of others. And our profiles are unique. Now, shall we jump into it then about the alternative model and hear more about it? Or what do you think? Yeah, yeah, I think we should, let's do okay. So we originally developed a prototype model, which was the entirely dimensional system, it was a bridge too far the task force of DSM-5, that's more than we can do. And so we actually had to regroup and think about what steps can we take that will be more comfortable and familiar, that was just moving too far away from traditional medicine, to learn new things, and I mean, it is it's just a total, it would be a totally different way to be thinking about what's intuitively what you're doing anyway, sometimes it's not even just medicine, it's insurance. It's I mean, it's just like, you're right, Kerry, I mean, and so we just couldn't just say, well, we're gonna go get on a different planet here. We had to really maintain familiarity. And so what we developed was really a hybrid system. And we developed a template, a format that we think actually has stood the test of time, and there's a lot of research that supports it now. It's been 10 years since this was actually published.

14:14

And what we came up with was first effort to define well, back to the question you asked earlier, what do we mean by personality? Well, what we mean is that everybody's got two main elements of personality functioning, a sense of self, and a capacity for interpersonal relationships. Yes, those are really the two main kind of foundations of anybody's personality. We unpacked a sense of self into a sense of identity, and a capacity for self directedness. Oh, do I know who I am? And do I know where I'm going? 

14:55

We enter personal relationships with two things called empathy and intimacy And Empathy means can I understand you? Can I understand the other person? Can I put myself in your shoes and see the world through your eyes, many of us are good at that. Some of us are not, when we're not, that can be a problem. And the other feature of interpersonal relationships is intimacy. And that's not meant in a romantic sense, so much as a capacity for mutually gratifying, lasting, long term relationships. So if I'm thinking about my personality, do I know who I am? Do I know where I'm going? Do I understand that I might interested in other people? And do I have good relationships with other people. And if you just use that as a, as a sort of a generic template for understand personality, then you can then begin to think about okay, then what does it mean when something goes wrong, we developed an impairment in functioning. And the definition generically that we came up with using the alternative model was moderate or greater impairment in personality functioning in at least two of these four areas. And we actually had a good database that helped us clarify that threshold, that was the appropriate one, on a scale from none to extreme, moderate impairment was the cut point that was appropriate to define, in generic terms, the philosophy of impairment in functioning, you could have some trouble, you could have some difficulty, you could have some mild impairment, but you're not going to have a personality disorder. And so that's how we defined the template. And then we left on a hybrid system, the second criteria. And so the first criterion is impairment in functioning in these four areas that I talked about. Identity, and self directedness, and empathy and intimacy. The second criterion is the presence of one or more pathological personality traits. You want to say more about that. And we developed actually based on a lot of traits, psychology research that's been enormously important in the literature, by trait domains, where there can be impairment based on pathology, and those are negative affectivity, detachment, antagonism, disinhibition, and psychoticism. Now I'm fast forward, again, parentheses here, just to say one thing, if we had more time, it'd be fun to go into the International Classification of Diseases. ICD-11 is the most recent version of the international classification system of all medicines, what the rest of the world uses, and what we use for billing. Yeah, that's right. And the ICD-11 has come up with a totally new dimensional system for personality disorders. And they have one personality disorder called personality disorder, that's characterized by impairment in five domains. Wow. And the level of impairment is from zero to six, very, very parallel to the alternative. And are they similar domains, what you just described, very similar. In fact, I can tell you about that. Just give me a second. While you're pulling that up, I just want to say I use the alternative model quite a bit in regard to diagnosing. And while I think like on first shot, a lot of my patients are like, wait, what does it mean that I have a trait specified personality disorder, they get kind of confused, but ultimately, it does seem like it captures their experience so much. More precisely. And ultimately, I think they feel very, very understood. Like, yes, that is the thing that brought me to treatment, the way that it's been described it, it does feel so much more precise, a great point carry. And that's what we've all found that, in fact, when you're trying to work this clinically, people find it very intuitive. It makes sense. It's a language that makes sense. But back to the question you asked in terms of trade domains, the ICD-11 has the following negative affectivity. Same as the alternative model, detachment, same as the alternative model, this inhibition, same as the alternative model, they dug up an old term hold this sociality same as our model of our domain of antagonism. Then they pulled back one called. Oh, that's an old term. But in essence, it correlates with rigid perfectionism. Used

19:38

OCD, but way back, so they kind of think maybe they just copied from you. Well, they would never

19:47

there was clearly a convergence, and this is fine. So there's an alignment now. And actually, we had a big meeting and and Copenhagen actually have the international

20:00

organization, there was a lot of push back to the ICD group for not including borderline on their new system. And ultimately they agreed to do that. So there's one specifier in their system, which is more has particular personality and disorder, really, on the other hand, retained, antisocial, avoidant, borderline.

20:22

Obsessive compulsive. And schizotypal is our hybrid model that keeps us the most important categorical terms that we're familiar with. But we didn't keep paranoid schizoid, histrionic, or dependent because the research literature was very weak to support the as conditions with construct validity. They are syndromes when there are things that we can talk about pathological traits, facets, give you a layout, they always seem kind of just like traits that a variety of things might have that right, there was one than the earlier editions of DSM called passive aggressive personality disorder. But that's a trait and we know people who were like, exactly, well, I wonder if we want to kind of move into I'm going back to an idea that that we talked about that everybody has a personality, it can become

21:17

an area where people face impairment in their life. But one of the things that you have worked on is to create a way for people to understand their personality, and to see maybe areas where it could be, just start to get funky. If you review, you call this the new personality, self portrait, I get that right, you did. And let me jump in. And just tell you about that. Because there are times when

21:41

I was very lucky way back and get some three days on an APA meeting to meet a very talented journalist and medical writer named Lois Morris. And we got a chance to talking and decided that there's time now because we have such progress with DSM three, to talk about personality in an educational way that we can tell the public about it and get people interested. We wrote this book and the first version was called my personality self portrait. And I actually developed a self assessment test in the book that you could self score. And it was really derived from the work we did at Cornell developing a semi structured interview for all of DSM-3 personality disorders called the personality disorder examination, that can play what I did was I turned the volume down of each of the disorders, until it became a non pathological trait. That's what we call in the book a continuum. So that, for example, if you have obsessive compulsive personality disorder, you turn that volume down, you have conscientiousness? Yeah, it can be very useful, and very helpful. If you have narcissistic personality disorder, you turn that volume down, and it becomes self confident personality traits, very useful. And so this was the scheme that we used to help people start then at the non pathological side, and recognize that there are a whole universe of types of personalities based on the richness of these traits. One other thing that we did later, and by the way, we struck the right chord, because this book has now been continuously in print for over 30 years. 

23:30

Come on, way to go. It's still in print. But along the way, we developed a good partnership with elope madonn, who was at mentor, one of our good research psychologist, and he joined us and developed a web based version of the test. And so that's the website NPSP25.com. And that stands for the new personality self portrait. And I put 25, because it was the 25th year of the book, when we started out with 

23:59

oh, I didn't know. That makes sense. 

24:01

We put it up on the web, at first, at no cost for just no marketing just to see what what happened. And a couple of years, it was amazing, over 12,000 people worldwide. 

24:12

So it gives you a database. 

24:14

But we had an international sample, which is really cool. So when you take the test now online, you get a percentile rank for each of the styles to show you where you land compared to this international sample all across the world. And it's really interesting, what why should a person go on and do this? What why? I mean, you it's kind of implicit in what you're saying, but what's the benefit of knowing these things? Well, because we are always totally able to see ourselves with complete access for sure. Right. Right now, so sometimes other people see traits and features and us that we don't think really are typical of us, but generally I think we're pretty good at knowing

25:00

But we're strong in terms our particular styles and what maybe not so strong. But there are some surprises. And so it's really helpful to see what your particular profile looks like. I took the test years ago, and I also asked my identical twin brother. I didn't know you had an identical twin brother. He's a lawyer.

25:24

Our results were not that surprising. Most of our traits are in the rough, same ballpark, except one on the one where he was much higher than I was called aggressive.

25:37

So well selected for profession. Yeah. 

25:40

So you two took the test. What did you think yourself? 

25:43

Well, first of all, I'd say like, it's a just for listeners, It's an easy to take tests because you know, when I've asked you a bunch of questions, some rather involve that took some thinking, I think and, and you basically say yes or no, so some of you kind of go through pretty quickly. 

25:57

And I have to say it as a psychologist who does psych testing, it was really exciting for me to do, like one that I didn't know too much about where I would invalidate it. Like it was just really fun to get to be on that side of the coin. And I for me looking at the results, which again, I'm excited to hear some of your hot takes Dr. Oldham, but I was not surprised. I was like, I was like, There she blows 

26:21

You have good self knowledge. 

26:21

Yeah, I was I mean, I my highest points were conscientiousness, and dramatic. And even on other episodes, I have made the joke that if I was going to have a personality disorder, which I don't think I do, but if I was, it would either be OCPD, or histrionic. So I feel like I kind of landed among where I expected to me. 

26:38

You nailed it. Yeah.

26:41

But isn't that sort of gratifying and interesting to actually get that result and sort of confirm what you think about yourself.

26:52

It also is important to point out that this test does not diagnose pathology, does not reflect pathology, this reflects what your strongest traits are, and what the traits are, that you're not particularly that are not typical of you. And it's amazing how different these graphs can be. There's no point where like, where this will break down the test and say, like, you really need to see a doctor or something. No, but on the other hand, if some of your traits are at the top of the scale, it could be tipping you off that you might be having some, you'll be tripping yourself up a little, because you're too prominent and a little too strong in that particular trait. And maybe you should check it out. So I'm, again, if this is even remotely in the ballpark of something you would be comfortable doing. If you looked at my chart, what what's your what's your hot take? Well, I don't know you that? Well, Kerry, but I was not that surprised.

27:49

One thing you're doing right now is you're sitting in front of a camera and you're doing something that is dramatic, you'd like to be sort of one of the players, you're not going to be sort of invisible in the backseat between. You're also very conscientious because you're a successful professional. That almost goes without saying I

28:12

don't think I experienced you to the degree that I've gotten to know you as very aggressive. I don't think I would see you as Yes. Once you get to know her. Yeah. Comes down now. Well, that's an important point. You just made me realize you were making Bob, which is the once you get to know you

28:30

talk about your your results. What did you thought I was kind of depressed? I thought it was pretty flatline. There. I don't know, I was kind of worried is the personality equivalent of low blood pressure? Yeah, that's kind of Yeah, one of the questions we were talking about thinking about this program was any thoughts on how we did you ask? And my answer in my head was, you did great.

28:53

There's no right or wrong.

28:56

And in fact, some people are higher, with lot more blue color on the part. You saw that a little bit and some carries traits. But some people are more reserved. So let's say that you're more on the reserve side, if you go back to those old fashioned words of introvert and extrovert, a less of an extrovert more reserved, and that kind of checks. I've known you for a while Bob. And I think that it's to me, because you tend to hold back and not be the first guy shooting up your hand when a question is asked, and particularly if it's an audience that you don't know that well, fair enough, makes you a good leader. That's a that's a really positive spin. I listen, I think that's a good point. Because the best leaders you can be is to be able to lead by following I that's just a very small anecdote. When I interviewed and Bob was obviously in one of the my interview panels. I was like, oh my god, this is the new chief of staff. I hadn't met you in my training years. I

29:59

You came into the gap while I was away and met you yet and I was like ready to be grilled. And you had just such a steady eat. Let other people ask them the questions you asked, you asked at the end, and they were very nice questions, but you were not like jumping in hot you like let other people ask the question. But enough about me. I do want to mention this very, very podcast, you're going to say that for listeners who would like to take the test, we have a special offer, is that, right? Yes. Was this a discount code? So you can take the you can yourself take the new personality, self portrait inventory, and it is on NPSP25.com. Okay. And when you go, it's very intuitive. It's like, take the test. Like that's like one of the buttons on the home screen. And then when you go to do it, you can get 50% off the cost to take the test if you put in the code, MENN2023, which is MENN2023. 

30:56

Wow, that's a that's first time we've had like a I know. And it's really I really enjoy it was very, I thought was very informative. Yeah. And I think to the to your point, it was gratifying. And I said this, I'm going to say it again. Dr. Oldham, one of the things I just so appreciate, is I think you have this this even this test, it takes things that oftentimes can, especially in the field of psychiatry, be used to weaponize kind of like how people exist in the world. And instead it celebrates it. That instead of saying, Gosh, Kerry you're so histrionic, it was like, oh, there's part of your personality is dramatic, and that this is a part of how you are and how you exist. And I think that that's a really beautiful thing. I think it helps. It's a very strength based, compassionate way of seeing things. Yeah. Well, thank you. Let me make one last point, if I correct, okay, you're gonna get the last word. So that's it, go ahead. For me, okay. But on the website, we developed a new feature, which is a lot of fun, which is called the group self portrait, we're actually going to simplify that it's a little tricky to do right now. But what you can do is superimpose two different graphs on top of each other. And go and look at the website, look at the samples that you can go to, which are at the top, there's a set

32:11

sample profiles. These are stories about couples, and how they were alike, and how they were different. And at the, it shows their particular graphs, their self portrait graphs, and it puts one on top of the other, so that you can then in different colors, see immediately how you're like and how you're different. And it will toggle back and forth between the two graphs. So I'm looking at one right now, where,

32:40

man in the couple, Henry is up, very strong in terms of self confidence, much more so than the woman. But she is in fact narrative much stronger in terms of devoted and sensitive so they are very different. So you know, there are two little slogans that we're very familiar with, which are birds of a feather flock together. And opposites attract.

33:06

Seems like a good cup, both. And so what you learn is how you're like and how you're different. And there are often surprises, yes. When you think about each other. And this is a way actually you can think about what kind of job works best for me. What kind of workplace should I be in? What kind of relationship is likely to be best for me? And you can do all kinds of things. So I could talk a lot more, maybe. I wish we I wish we could but we have to stop and because there's nothing more interesting, I think, than personality. And we we've really again, not just us, many, many people just appreciated the work you've you've done in this part of the field, Dr. Oldham and thank you for coming and sharing with us. Yeah, so we've been talking with Yeah, I mean, it's we've been talking with

33:49

Thanks so much. We've been talking with Dr. John Oldham. And so we're your hosts. I'm Bob Boland, I'm Kerry Horrell. Thanks for diving in.

33:58

The Mind Dive Podcast is presented by the Menninger Clinic. If you're curious about the professional experiences of mental health clinicians, make sure to subscribe wherever you listen. For more episodes like this, visit www.MenningerClinic.org. To submit a topic for discussion, send us an email at podcast@menninger.edu