Off the Couch Psychology

What if calming your mind sometimes starts with your body?

In this crossover episode of Quest for Success Podcast and Off the Couch Psychology Podcast, Dr. Jerry Cunningham explores practical ways to use your body to change the intensity of what you're feeling. You'll learn why breathing, facial tension, movement, your senses, and even temperature can influence your emotional state—and what you can do when stress, anxiety, anger, or feeling overwhelmed starts taking control.

You'll discover the physiological sigh, the 5-4-3-2-1 grounding technique, facial feedback, temperature shifts, and simple movement strategies you can use in everyday life. More importantly, you'll learn how to recognize your body's warning signs before your emotions reach the point where your mouth starts making decisions your brain may have to apologize for later.

• Use breathing to reduce physical arousal and regain control.

• Recognize tension in your jaw, face, shoulders, and muscles as early warning signs.

• Use your senses to interrupt emotional spirals and reconnect with the present.

• Move your body when stress has created physical activation.

• Create space between what you feel and what you do.

• Practice these strategies before you desperately need them.

For more episodes and resources, visit Quest-Success.com.

Yilmaz Balban, M., et al. (2023). "Brief Structured Respiration Practices Enhance Mood and Reduce Physiological Arousal." Cell Reports Medicine. This randomized controlled study examined several breathing practices and found that five minutes of daily breathwork, particularly exhale-focused cyclic sighing, was associated with improved mood and reduced respiratory rate.

Coles, N. A., Larsen, J. T., & Lench, H. C. (2019). "A Meta-Analysis of the Facial Feedback Literature: Effects of Facial Feedback on Emotional Experience Are Small and Variable." Psychological Bulletin. A useful scientific look at the facial-feedback hypothesis; importantly, the researchers found that the effects exist but tend to be small and vary across circumstances.

Levine, Peter A. — Waking the Tiger: Healing Trauma. Levine explores the relationship between trauma, bodily sensations, nervous-system responses, and body-based approaches to regulation.

Dialectical Behavior Therapy (DBT) Distress-Tolerance Skills. For listeners interested in going deeper, DBT provides a broader framework for managing periods of intense emotional arousal through practical distress-tolerance and regulation strategies.

#AndrewHuberman #PeterLevine #WakingTheTiger

What happens when a child learns early in life that the people they need most cannot always be trusted?

In this episode of Off the Couch Psychology Podcast, you'll get a clearer understanding of Reactive Attachment Disorder (RAD), a condition associated with severe disruptions in early caregiving and a child's ability to form healthy attachments. You'll learn what RAD can look like beyond the labels of "defiant," "cold," or "unloving," and why some children may reject the very comfort they desperately need.

We'll look at what may be happening in the developing brain, how early neglect and unstable caregiving can shape a child's expectations of relationships, and why simply placing a child in a loving home may not immediately erase those lessons.

You'll also hear the disturbing story of Theodore, a troubled little boy who eventually became known to the world as Ted Bundy. His story raises an important question about childhood trauma and intervention while also reminding us that there is no documented RAD diagnosis for Bundy and that RAD does not predict serial violence.

Most importantly, you'll learn how consistent caregiving, professional treatment, family involvement, and repeated experiences of safety can help a child begin building something they may never have learned to expect: trust.

• RAD involves much more than difficult or defiant behavior.

• Severe neglect and disrupted caregiving can interfere with a child's ability to seek and accept comfort.

• A safe home is important, but rebuilding trust can take time and repeated experiences of dependable care.

• Treatment should involve qualified professionals and often includes caregivers as part of the process.

• Coercive or frightening "attachment therapies" can be dangerous and should be avoided.

• A child's difficult beginning does not determine the ending of their story.

For more episodes, resources, and information from Dr. Jerry Cunningham, visit Quest-Success.com.

American Academy of Child & Adolescent Psychiatry — Attachment Disorders A family-focused resource for understanding attachment disorders and the importance of proper assessment. AACAP Facts for Families: Attachment Disorders

Ellis, Yilanli & Saadabadi — "Reactive Attachment Disorder," StatPearls A clinical overview covering symptoms, diagnostic criteria, evaluation, and management of RAD. Read Reactive Attachment Disorder — StatPearls

American Academy of Child & Adolescent Psychiatry — Policy Statement on Coercive Interventions for Attachment Disorders Important guidance concerning appropriate treatment and the dangers associated with coercive attachment interventions. Read the AACAP Policy Statement

Boris & Zeanah — Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder A detailed professional resource on assessment, caregiver relationships, treatment, and attachment-focused care. Read the AACAP Practice Parameter

#TedBundy #TheBoarder #TroubledChild

Do you need help healing something from your past—or help figuring out what to do next?

Therapy and life coaching can both help people make meaningful changes, but they are not interchangeable. In this crossover episode of Quest for Success Podcast and Off the Couch Psychology Podcast, you'll discover where therapy and coaching differ, where they overlap, and why choosing the right kind of help matters.

Through real-world examples, humor, and a little Good Will Hunting, we'll look at how therapy can address emotional distress and unresolved issues while coaching can focus on goals, habits, performance, accountability, and forward movement. You'll also hear what can happen when a coaching conversation uncovers something deeper that may need the attention of a mental health professional.

• How therapy and coaching serve different purposes

• Why looking backward can sometimes help you move forward

• When goal setting and accountability may be useful

• When a coaching issue may actually require therapy

• How therapy and coaching can sometimes complement each other

• Questions to consider when deciding what kind of help you need

For more episodes and resources, visit Quest-Success.com.

American Psychological Association — Understanding Psychotherapy and How It Works — A practical overview of psychotherapy, what it addresses, and how the process works.

International Coaching Federation — Guide to Experiencing Coaching — Explains coaching, its focus on growth and goals, and important distinctions between coaching and therapy.

International Coaching Federation — Coaching vs. Therapy — A resource specifically addressing the differences and areas of overlap between the two approaches.

Atomic Habits — James Clear — The book discussed in this episode explores how small, consistent changes and better systems can produce meaningful behavior change. Learn more about Atomic Habits

American Psychological Association — How to Choose a Psychologist — Includes signs that professional psychological help may be appropriate and guidance on finding a psychologist.

#GoodWillHunting #MichaelPhelps #SerenaWilliams #JamesClear #AtomicHabits #MattDamon #RobinWilliams

What happens when someone craves ice, paper, dirt, or even pieces of sheetrock—and cannot simply promise to stop? In this episode of Off the Couch Psychology Podcast, you will meet Jenny, whose behavior began with eating paper as a child and continued through adulthood and three pregnancies.

Through Jenny's story, you will discover what pica looks like beyond its clinical definition, why people often hide it, and how shame can prevent them from seeking help. You will also learn about possible nutritional, medical, and emotional factors behind these cravings. Most importantly, you will hear how medical testing, prescribed supplements, cognitive behavioral therapy, safer replacement behaviors, and practical changes at home can help someone move forward.

If you have ever wondered why someone would eat non-food substances—or why stopping can be so difficult—this episode offers answers without ridicule or judgment.

• How to recognize the major signs of pica

• Why iron and zinc deficiencies may matter

• Medical dangers connected with non-food substances

• How CBT can help someone respond to cravings

• Why support works better than shame

Find more episodes and resources at www.Quest-Success.com.

• Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision

• Pica: Symptoms, Causes, and Treatment — Cleveland Clinic

• Pica — MSD Manual

• Pica — StatPearls, National Library of Medicine

• The Association Between Pica and Iron-Deficiency Anemia

#MyStrangeAddiction #TLC

What happens when someone breaks a rule nobody ever said out loud? An elevator ride turns awkward. A family dinner goes quiet. A conversation about money becomes an argument, and neither person knows how it started.

In this crossover episode of Quest for Success and Off the Couch Psychology, you'll hear how unwritten rules shape what feels safe, what causes tension, and what you expect from the people closest to you. Through the Crenshaw family's story, you'll see how some rules bring people together while others make it hard to speak up. You may even recognize a rule you've been following for years without knowing it was there.

Key Takeaways

• Notice the unspoken expectations behind everyday conflicts.

• Recognize family rules worth keeping and rules worth questioning.

• Understand why a small change in behavior can cause a big reaction.

• Start a conversation without expecting someone to read your mind.

• Examine the money beliefs your family passed down.

Listen in, then visit www.Quest-Success.com for more.

Suggested Reading

• Harold Garfinkel, Studies in Ethnomethodology.

• Judee K. Burgoon, "A Communication Model of Personal Space Violations: Explication and an Initial Test".

• Harriet Lerner, The Dance of Anger.

People and Shows Mentioned

#HaroldGarfinkel #JudeeBurgoon #Bridgerton #LadyWhistledown #Mandy

What happens when you know exactly what you want to say, but anxiety will not let the words come out? Selective mutism is often mistaken for shyness, stubbornness, or a child simply refusing to talk, but there is much more happening behind the silence.

In this episode of Off the Couch Psychology Podcast, you'll meet nine-year-old Amber and follow her through a typical day to see how selective mutism can change dramatically from home to school. You'll learn why a child may talk nonstop around family yet struggle to say a single word in another setting, what anxiety and the brain's fear response have to do with it, and why telling someone to "just talk" can actually make speaking harder.

Most importantly, you'll discover how gradual exposure, stimulus fading, positive reinforcement, speech-language support, family involvement, and other treatment approaches can help someone slowly expand where and with whom they can comfortably use their voice.

If you've ever wondered what is really happening behind selective mutism—or how you can better support someone experiencing it—this episode is for you.

• Selective mutism is not simply a choice to remain silent.

• Anxiety can make speaking extremely difficult in particular settings.

• Pressure and coercion can increase anxiety rather than improve communication.

• Small, gradual speaking experiences can help build confidence.

• Parents, schools, therapists, and speech-language professionals can work together to support progress.

• The goal is not to force a voice out, but to make using that voice feel safer.

For more episodes, resources, and information from Dr. Jerry Cunningham, visit Quest-Success.com.

American Speech-Language-Hearing Association — Selective Mutism. A detailed overview of assessment, behavioral and cognitive-behavioral approaches, exposure, desensitization, stimulus fading, speech-language services, and treatment across settings. Read the ASHA Selective Mutism guide

Selective Mutism Association — Treatment Statement. Explains why selective mutism should be approached through anxiety reduction rather than pressure to speak and discusses gradual movement from nonverbal to verbal communication. Read the Selective Mutism Association Treatment Statement

Selective Mutism Association — Treating Selective Mutism. An accessible resource covering behavioral and cognitive-behavioral treatment, psychotherapy, medication, and speech-language intervention. Explore Selective Mutism treatment options

American Academy of Child & Adolescent Psychiatry — Anxiety and Children. Provides additional information about childhood anxiety, including selective mutism and when professional evaluation may be appropriate. Read AACAP's guide to childhood anxiety

James Clear — Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones. Mentioned in the episode for its broader concept of making change easier through small, manageable steps. Selective mutism itself is not a habit, but the book's small-step concept provides a useful analogy for understanding gradual progress. Learn more about Atomic Habits

#AtomicHabits #JamesClear

Losing weight is supposed to make you feel better—but what happens when the scale goes down and your anxiety, depression, or body-image struggles don't go with it?

In this episode of Off the Couch Psychology Podcast, you'll discover why improving your physical health doesn't automatically resolve what's happening psychologically. We'll look at research involving restrictive dieting, unhealthy weight-loss methods, bariatric surgery, and significant weight loss—and why the way you lose weight may matter as much as the number of pounds you lose.

You'll also meet Kathy, a woman who believed bariatric surgery would finally help her feel comfortable with herself. Her experience shows how anxiety about regaining weight, changes in eating, loose skin, old emotional wounds, and unrealistic expectations can follow someone even after successful weight loss.

If you're losing weight, considering weight-loss treatment, or supporting someone who is, this episode will help you think beyond the scale and focus on becoming healthier both physically and mentally.

• Weight loss can improve health without automatically eliminating depression or anxiety.

• Extreme or unhealthy weight-loss methods can be associated with greater psychological distress.

• Major weight loss may create unexpected challenges involving food, body image, and fear of regaining weight.

• Bariatric surgery often improves mental health, but some people continue to struggle or experience new psychological concerns. (PubMed)

• Mental health deserves to be monitored along with weight, nutrition, and physical health.

• Successful weight loss should be measured by overall health—not simply the number on the scale.

For more episodes and resources, visit Quest-Success.com.

1. Law et al. (2023), "Bariatric Surgery and Mental Health Outcomes: An Umbrella Review." A broad review examining both the mental-health benefits and potential psychological risks associated with bariatric surgery. (PubMed) Read on PubMed

2. Castaneda et al. (2019), "Risk of Suicide and Self-Harm Is Increased After Bariatric Surgery." A systematic review and meta-analysis examining self-harm and suicide risk following bariatric surgery. (PubMed) Read on PubMed

3. Martinelli et al. (2024), "Bariatric Surgery and New-Onset Substance Use Disorders." Research examining the risk of developing new substance-use problems following bariatric surgery. (PubMed) Read on PubMed

4. "Weight Loss Methods and Risk of Depression" (2025). An analysis of more than 9,000 adults that distinguishes healthier weight-loss approaches from potentially harmful strategies associated with depressive symptoms. (PubMed) Read on PubMed

5. "Depressive Symptoms at Short-, Medium-, and Long-Term Follow-Up After Bariatric Surgical Procedures" (2025). A systematic review of more than 13,000 people showing that depressive symptoms generally improve after bariatric surgery while also identifying a subgroup whose symptoms worsen. (PubMed) Read on PubMed

Your child can't focus, avoids homework, struggles in class, or seems restless. Is it ADHD—or could anxiety be driving the behavior?

In this episode of Off the Couch Psychology Podcast, Dr. Jerry Cunningham breaks down why ADHD and anxiety in children can look surprisingly similar on the outside while very different things may be happening underneath. You'll learn what research tells us about attention, mistakes, worry, task avoidance, and social situations—and why understanding the reason behind a child's behavior matters.

Through the stories of Kavion and Rhonda, you'll hear how ADHD-related distractibility can differ from attention that gets hijacked by fear, perfectionism, or worry. You'll also learn practical clues parents and teachers can watch for and how those observations can help professionals make a more accurate diagnosis.

If you've ever wondered whether a child's difficulty concentrating is ADHD, anxiety, or possibly both, this episode will give you a clearer way to think about the question.

• ADHD and anxiety can produce similar-looking attention problems for different reasons.

• ADHD may involve broader difficulties regulating and sustaining attention.

• Anxiety can pull attention toward worry, threat, mistakes, and fear of judgment.

• Task avoidance can come from distractibility or from fear of failure and perfectionism.

• Patterns across home, school, and social situations provide important diagnostic clues.

• ADHD and anxiety can occur together, making a thorough professional evaluation important. (American Academy of Pediatrics)

For more episodes, articles, books, and resources from Dr. Jerry Cunningham, visit Quest-Success.com.

1. American Academy of Pediatrics — Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents. The guideline emphasizes evaluating symptoms across multiple settings and screening for conditions such as anxiety that can coexist with or resemble ADHD. (American Academy of Pediatrics) Read the AAP guideline

2. Jarrett & Ollendick — "Attention Mechanisms in Children With Anxiety Disorders and in Children With Attention Deficit Hyperactivity Disorder." This is the study discussed in the episode comparing attention patterns in children with ADHD and anxiety, including selective and sustained attention and attention toward threatening faces. (PubMed) View the study on PubMed

3. American Academy of Child and Adolescent Psychiatry — Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders. Reviews evidence supporting treatments including cognitive behavioral therapy and, when appropriate, medication. (PubMed) View the anxiety guideline on PubMed

4. Centers for Disease Control and Prevention — Diagnosing ADHD. A practical overview explaining why there is no single test for ADHD and why clinicians consider other possible causes of similar symptoms, including anxiety. (CDC) CDC: Diagnosing ADHD

5. Centers for Disease Control and Prevention — Treatment of ADHD. Covers behavior therapy, parent training, school interventions, and medication recommendations for children with ADHD. (CDC) CDC: Treatment of ADHD

#ADHD #Anxiety #ChildhoodAnxiety #ChildPsychology #MentalHealth #Parenting #Attention #CognitiveBehavioralTherapy

When does clutter become something more serious? Hoarding disorder isn't simply having a messy house or refusing to throw things away. The possessions you see are often only the visible part of a much more complicated struggle.

In this episode of Off the Couch Psychology Podcast, you'll learn what separates hoarding disorder from ordinary clutter and collecting, why getting rid of seemingly worthless objects can cause genuine distress, and how decision-making and emotional attachment can keep the cycle going. We'll also step inside a realistic hoarding scenario to see what the disorder can look like for the person experiencing it—and why family members saying, "Just throw it away," rarely solves the problem.

You'll also hear about specialized CBT for hoarding disorder, in-home interventions, reducing excessive acquiring, the Buried in Treasures approach, and why cleaning out a home without treating the underlying problem may not produce lasting change. (American Psychological Association)

If you've watched the television shows and wondered, How does someone get to this point?, this episode takes you beyond the piles and into the psychology behind them.

• Hoarding disorder is different from ordinary clutter, collecting, and OCD. (American Psychiatric Association)

• Difficulty discarding often involves powerful emotional attachments, beliefs about usefulness, and distress over making decisions.

• Forced cleanouts may change the environment without addressing the psychological patterns behind the hoarding.

• Specialized CBT can target discarding, acquiring, organization, and decision-making skills. (Hoarding)

• Progress is about making a home safe and functional—not turning someone into a minimalist.

• Long-term improvement requires continuing to practice new ways of relating to possessions.

For more episodes and resources, visit Quest-Success.com.

Tolin, D. F., Frost, R. O., & Steketee, G. — Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding, 2nd ed. This is the book behind the Buried in Treasures approach discussed in the episode. (Oxford University Press) Buried in Treasures — Oxford Academic

Steketee, G., & Frost, R. O. — Treatment for Hoarding Disorder: Workbook, 2nd ed. A research-based workbook focused on CBT strategies for hoarding disorder. (OUP Academic) Treatment for Hoarding Disorder: Workbook

American Psychological Association — "Treating People With Hoarding Disorder." An accessible overview of the characteristics, research, brain science, and treatment of hoarding disorder. (American Psychological Association) Read the APA article

International OCD Foundation — "Treatment of HD: Cognitive Behavioral Therapy." More information about specialized CBT and the role of practicing sorting and discarding within the home. (Hoarding) Read about CBT for Hoarding Disorder

Mayo Clinic — "Hoarding Disorder: Diagnosis and Treatment." A useful overview for listeners wanting to learn more about evaluation and treatment options. (Mayo Clinic) Mayo Clinic Hoarding Disorder Guide

#HoardingDisorder #BuriedInTreasures #GailSteketee #RandyFrost #DavidTolin #HoardingShows

For years, severe premenstrual symptoms were sometimes dismissed as simply "bad PMS." But Premenstrual Dysphoric Disorder—PMDD—is a recognized disorder that can seriously affect mood, relationships, work, and everyday functioning.

In this episode of Off the Couch Psychology Podcast, you'll learn what separates PMDD from typical PMS, why the timing and pattern of symptoms are so important, and why the problem may involve the brain's response to normal hormonal fluctuations rather than simply having "too many hormones." You'll also meet Connie and see how PMDD can play out in everyday life when ordinary situations suddenly feel much harder to manage.

Most importantly, we'll explore what can actually help. From symptom tracking and therapy to SSRIs, hormonal approaches, lifestyle strategies, and emerging areas of research, you'll get a practical introduction to the treatment options being studied and used today.

If you—or someone you care about—seems to become a dramatically different person during the same part of the menstrual cycle each month, this episode may help you understand why.

• American College of Obstetricians and Gynecologists (ACOG), "What I Wish Everyone Knew About Premenstrual Dysphoric Disorder." A listener-friendly overview of PMDD symptoms and treatment. (ACOG) Read the ACOG PMDD overview

• American College of Obstetricians and Gynecologists (ACOG), Clinical Practice Guideline: Management of Premenstrual Disorders. Evidence-based guidance covering diagnosis and pharmacologic, psychological, lifestyle, and other treatment approaches. (ACOG) Read the ACOG clinical guideline

• Mishra, S., Elliott, H., & Marwaha, R., "Premenstrual Dysphoric Disorder," StatPearls. Reviews diagnostic criteria, symptom patterns, biology, assessment, and treatment. (NCBI) Read the StatPearls PMDD review

• Cochrane Review, "Selective Serotonin Reuptake Inhibitors for Premenstrual Syndrome and Premenstrual Dysphoric Disorder." Reviews evidence for SSRI treatment, including continuous and luteal-phase dosing. (PubMed) View the review on PubMed

• PMDD is more than ordinary PMS; symptoms can significantly interfere with relationships, work, and daily functioning.

• The cyclical timing of symptoms is an important part of recognizing PMDD.

• Daily symptom tracking across menstrual cycles can provide valuable information for diagnosis and treatment planning.

• PMDD appears to involve an increased sensitivity to normal hormonal fluctuations rather than simply abnormal hormone levels.

• Treatment may include SSRIs, hormonal approaches, psychotherapy, lifestyle strategies, or a combination of approaches. (ACOG)

• Newer treatments are being researched, but experimental approaches should not be confused with established PMDD treatments.

For more episodes, resources, and information from Dr. Jerry Cunningham, visit: Quest-Success.com