There are a bunch of good stimulant abuse cases in the literature that present as “patient’s boss said she was unusually standoffish and wanted her to get psychiatric evaluation”, show up in the office as “well of course I’m standoffish, everyone in my office excludes me from everything and is rude in a thousand little ways throughout the day”, and end up as “cut your Adderall dosage in half, please”. NPR has a good article, A Life Without Fear, describing some of what they go through: Kids and adults with Williams love people, and they are literally pathologically trusting. Researchers theorize that this is probably because of a problem in their limbic system, the part of the brain that regulates emotion.
A friend breaks off two appointments in a row, each time saying that something has come up – did something come up, or is he getting tired of the friendship?” And later, my supervisor was reviewing one of my therapy sessions, and I was surprised to hear him comment that I “seemed uncomfortable with dramatic expressions of emotion”.I mean, I am uncomfortable with dramatic expressions of emotion. As a therapist, I’m supposed to be quiet and encouraging and not show discomfort at anything, and I was trying to do that, and I’d thought I was succeeding.But apparently I was unconsciously projecting some kind of “I don’t like strong emotions, you’d better avoid those” field, and my patients were unconsciously complying.I wish I could say my supervisor’s guidance fixed the problem and I learned to encourage emotional openness just as well as my colleague.