B (4:56)

Well, thank you so much for Joining us today, Dr. Marks.

C (4:59)

Thanks for inviting me on.

B (5:01)

So I would love for you to.

A (5:02)

Start by telling us a little bit.

B (5:04)

About your journey into psychiatry. What made you pick that specialty?

C (5:08)

It's actually a little bit of an indirect route into psychiatry. So I was initially interested in becoming an internal medicine doctor. Actually in college I was interested in being an engineer, electrical engineer, and this is so immature of me, but I didn't want to be a doctor because I'm like, they wear white coats. That's boring. Who wants to do that? So I did engineering but but then I started having second doubts and decided after I graduated to then go to medical school because I really did want to help people. So in medical school though I grew up in the south where we're both in the south, we're both in Atlanta, but I grew up in Florida and in My environment. I had never talked to anyone who'd ever been to a psychiatrist before and really didn't see the value of it, the need for it. So it just was not even on my radar going into medical school. And in fact, I deferred the rotations on medical school. In your third year, there's all these required rotations that you have to do. The basic specialties, psychiatry being one of them, you're allowed to defer one for your fourth year. So I deferred psychiatry so that I could do research in internal medicine, which is what I was interested in. You know, it looks good for your applications to do research. Then. In my fourth year, when I got around to doing my psychiatry rotations, I was already in the thick of applying for residency in internal medicine. And I did the psychiatry rotation just to kind of get it out of the way. And I was super surprised at how interesting it was and how much satisfaction I got out of helping people with their emotional pain over tweaking someone's blood pressure medications. But I was too far down the road of applying for residency, which is kind of like a draft process. They call it the match, but you pick where you want to go places, pick you, and then you just get assigned somewhere. So I was too deep into that. So I matched in internal medicine. And I changed after the match. The place where I matched it in New York, the a psychiatry resident couldn't start because of an illness in the family, so they had an open spot. So they just switched me from one roster to the next. And so I was able to then start in psychiatry.

A (7:34)

Wow.

B (7:35)

It is almost as if this is where you were meant to be. It sounds like it really was.

C (7:40)

It really was where I meant to be. I mean, I've always been one who, probably to my detriment, have a little too much empathy sometimes. I'm one of those people who feels for people and things like that. And I've known that about myself, but still didn't equate that to I need to be a psychiatrist. But my mom said something that was very enlightening to me. She said I was telling her about some. This guy who looked, in retrospect, he was probably on the spectrum, but, you know, he was socially awkward and things. And I was talking about how he needed a friend. And my mom was like, you need to leave these people with problems alone. They need professional help. They don't need friends. Which sounds very harsh, but she was right in the sense of what I was tapping into is my desire to want to help People professionally.

B (8:34)

Thank you so much for sharing that. And you have done so many different things in your career, but most recently, you are doing a lot of mental health YouTube videos about psychiatry and mental health concerns. What led you down that specific career path?

C (8:49)

I started my own private practice in 2006, and what I noticed was I had been a part of someone else's practice before that, after residency. But when I was kind of seeing my own patients and whatnot, I would. I spent so much time teaching them things, and I thought, well, if they don't know these things, how many other people don't know these things? And also, I was trained to do therapy as well, not just prescribed medications. So I found that the kind of teaching them about their disorders took up too much time from talking about the real stuff, if you will, of their lives. And so the initially it was about creating a library of information that I could refer my patients to, hey, you know, you want to know more about this? Go look at this. But then I thought, well, but there's so many other people who could benefit from this. So it became about educating the world, if you will, more people than just the people I could see in my practice about basic mental health things.

B (9:51)

And what has been the balance in terms of you doing the videos on YouTube and your practice?

A (9:56)

Are you still practicing?

C (9:58)

I am still practicing.

A (9:59)

Okay.

C (10:00)

I have patients who I think fear that I'm going to let them go. And I mean, there's some of them I've been seeing for 20 years. So it's a relationship at this point. I can't just let go of them. But I've stopped taking new patients, so I'm still managing. It's still a lot of patients. It doesn't take up my whole week anymore. I get lots of inquiries about, can you just. One more patient, one more. Can you just take me? And the answer to that is, well, if I did, it would be Goodbye YouTube, because, you know, I really wouldn't have time to do anything else other than see patients all day long. And at this stage of my career, I want to do more than that, even though I still love seeing my patients. But I. I just want more.

B (10:46)

So you talked about a variety of different things on your channel. But one thing that we are going to talk more about today are personality disorders. So I think that, you know, the big ones that it feels like get a lot of attention are borderline personality disorder and narcissistic personality disorder. But we know that there lots of other personality disorders. Can you talk about, like personality disorders as like a set of diagnoses. And what does it mean to have a personality disorder?

C (11:15)

Sure. So yes, there are so many more personality disorders I think, you know, maybe like 10, I think is the number in total and they're grouped into clusters. So there's the dramatic or erratic cluster and that would be the ones that we hear most about Narcissistic personality disorder, borderline personality disorder, and then antisocial personality disorder fits into that. Then there's odd, eccentric, and that would be schizoid, schizotypal and paranoid. And then the third category would be anxious or fearful. And that would be avoidant personality disorder dependent and obsessive compulsive personality disorder, which is different from obsessive compulsive disorder. So the thing about personality disorders is I think this is kind of one thing that's generally misunderstood in the proliferation of information online about personality disorders. And that is we all have personality traits, but we don't all have disorders. So when you look at the Diagnostic and Statistical Manual of Mental Disorders and look at the criteria for the various disorders, anyone can have any of those single traits. So let's say, let's say with borderline personality disorder, if one of them is difficulty with your self identity or you know, emotional dysregulation, anyone can have those. But it doesn't have to mean you have that disorder. So with the disorders you have a collection of the traits that also cause dysfunction or problems in all aspects of your life, relationships, your work, and it may even affect you personally as well. So there's a threshold of these traits that pile on that then cause problems for you. One of the problems, unfortunately with personality disorders is that often people don't have enough self awareness to see themselves as having a disorder. There's a tendency to do what we call externalized blame. So you see the problem as your environment, other people, and it's not you. You probably can't just diagnose yourself with a personality disorder. And in fact there's another thing, another little pet peeve I have about hearing things online and then wanting to diagnose other people as being a certain disorder. We learned in my training when that we usually don't diagnose a personality disorder with the first evaluation because you're looking for longitudinal information, which is information that stretches a span of time. So how are you acting or what was going on in your late childhood and in adulthood over years and not just this kind of one slice in time as far as how do you have a personality or how it Develops. Going back to this kind of diagnostic question here, there's no one thing that causes personality disorders. It's a combination of the classic terminology that people will say, nature versus nurture. So the nature part would be what you come into this world with, genetics, your temperament. And then nurture would be your environment and the effect it had on you. So early experiences, how well you bonded and attached growing up or as you were being raised as a child, any trauma experiences, like all of those things, can intervene and lead you down the road of a disordered personality, because we all have personality. And then, last bit about personality disorders and how they come about, when they develop, they typically show themselves in late adolescence to early adulthood. That's when things start coming together enough to be able to see, is this someone with a personality disorder or just various aspects of different personality traits?

A (15:37)

So, Dr. Marks, would you say that.

B (15:39)

A personality disorder is something that could develop after like one season, singular traumatic event, or is it typically like a longer standing pattern of behavior and circumstances that would lead to a personality disorder?

C (15:54)

That's such a perfect second part to that question. It's the latter. It's not just one hit and then now you're impaired for life with this personality disorder. It's a series of things and experiences and reactions that you have that come together to form to result in a personality disorder. Again, I keep emphasizing that disordered part because we all have personalities. The presence of aspects of different personalities does not mean you are disordered. And disordered equals pathology. So not everything is pathology. That said, with something like complex PTSD versus regular ptsd, if you will, is. First of all, complex PTSD is a construct. It's not a diagnosis or official diagnosis like ptsd. But complex PTSD is thought to develop from multiple traumatic events. Like little hits. No, not necessarily little, but thousand stabs over time that start in your younger developmental years, such that the experience itself and your reaction to it infuses itself into your personality makeup, therefore potentially leading to a personality or a disordered personality as you get older.

A (17:23)

And what would you say you've already.

B (17:25)

Kind of talked about, like, one of the hallmark characteristics of personality disorders is this, like, lack of insight and ability to see yourself maybe as others do.

A (17:35)

Can you talk about why that is.

B (17:36)

Kind of a hallmark of this cluster of disorders?

C (17:40)

Sure. So, okay, I'm get a little bit heavy here with the kind of ego psychology here a minute. I'm sure you're fine with this, but I just want to warn the audience a minute. So there's a concept Called something that is ego syntonic versus ego dystonic. Ego syntonic would be something or things that go along with how you see yourself, how you feel, how you view yourself, such that you don't see it as a problem. Ego dystonic would be something or behaviors or experiences that go against how you see yourself. So an example of this would be the psychiatric disorders like depression and anxiety. Depression. The experiences that you have are different from how you see yourself. You know you have a problem because you are different versus with personalities tend to be ego syntonic. You don't see that you have a problem because it's built in to your nature or it's built into how you view the world. So for you, this is how things should be. And other people who don't like it, they're the ones with the problem. So another way to phrase that or to see that is having lack of insight that you don't see that you have a problem. And one of the results of this or what can happen is that often people with personality disorders don't come to treatment because of their personality disorder. They come to treatment either because they have something else, like depression, anxiety, something that's ego dystonic, that's causing problems for them that they see as a problem, or they come because a partner says, you either do this or I'm gone. But they normally don't just kind of walk into therapy saying I've got histrionic personality disorder and I want you to help me with that. It takes a lot of self awareness. And chances are if they did say that they've already had therapy to see that that's what their problem is.

B (19:44)

And I know this was different across disorders, different probably across the clusters. But what does treatment planning and a treatment process typically look like to help somebody who does have a personality disorder?

C (19:57)

Yes. So I know that at this point there are lots of different therapy modalities, many of which I'm not familiar with. When I trained, I trained in New York City, it was very psychoanalytical. A lot of my supervisor were analysts. And so it was very heavy into psychoanalysis and psychodynamic psychotherapy. So the approach to personality disorders was helping someone have insight. And that is my orientation when trying to help someone with this. That's not necessarily analysis, by the way, but just kind of insight oriented psychotherapy. And the, the approach with that would be from a high level view would be helping someone see what they don't see. So we all have blind spots and seeing patterns and trying to understand why you have certain reactions. Let's take an extreme example. If I believe that people who are stupid deserve to be punished or deserve to be criticized because they're stupid, okay, I can live believing that. But if I go out into the world and have a job or have relationships, somewhere along the line there's going to be a big old rub with me with that bad attitude. But I don't see it as a bad attitude. I just see it as. It just makes sense. If I had a patient who believed that, I would try and help them see how that belief causes problems for the people that they're around as well as for themselves. Because in that scenario, if I'm the person who believes that, I may not care that other people are insulted. There has to be something in it for me to feel like I need to change because of that. So what could that be? That could be me not seeming to get promoted and I can't understand why, or never being made a manager or my partner being mad at me all the time, like why? So I, as a therapist would help try and bring those examples in and then try and help deconstruct what causes people to have these kinds of reactions. Oh, what do you know? It's because this is what you think, helping them try and discover their flawed thinking. Essentially. There are other approaches. There's things like schema therapy and, you know, there's lots of different therapies today. I mean, I trained. I finished training in 2001. There's lots of therapies that came out since the 2000s that also can address personality disorders. But I will say no. I think my bias is no matter what the modality, it still takes time and patience and a lot of investment that some people aren't willing to make or just can't make money wise. But. But it's not something that changes overnight. Dialectical behavior therapy, that's another therapy that was designed originally for borderline personality disorder. But it can also help with coping skills and things like that for other people as well. So that's more of a cognitive behavioral format for helping a personality disorder. But typical programs with the way that it's set up last a year at least. And then often people will still need to repeat the year because there's certain segments that they go over. Long story short to that is that there's different ways you can approach addressing treating a personality disorder. I think the two biggest hurdles are the person seeing the need for it in the first place and then having the patience and the resources to be able to hang in there for an extended period of time. Because if you think about it, if you're thinking about going to therapy and you're Even if you're 25 years old, you're looking at at least a good decade or more of well ingrained reactions to life behaviors, knee jerk responses, attitudes that you're trying to undo or at least modify. And that takes time.

A (24:21)

More from our conversation after the break. These days, most things cost an arm and a leg, especially vacations. But not in Rhode Island. Between affordable luxury stays, succulent seafood right from the source, and spectacular shopping that won't break the bank, you get a real bang for your buck in the Ocean State. The memories will be priceless, but the cost will be a lot less. Rhode Island.

B (24:49)

All that.

A (24:50)

Plan your trip today@Visit Rhode Island.com that's Visit Rhode Island.com okay friends, real talk. You are worth the wait. We've all been there, giving our energy to connections that didn't honor ours and watching friends do the same. And honestly, we all deserve better. That's why Bumble is built for intentional dating. Safety is such a big deal for us all, especially when meeting new people. And Bumble gives you the peace of mind with options like photo and ID verification. That little extra step means you know the person you're talking to is who they say they are with their real photos, and they are ready to show up authentically. And once you feel safe, you can actually focus on what matters. Finding someone who gets you with shared interests. It's easy to see right away who vibes with your passions, whether that's true crime, podcasts, yoga mornings or weekend hikes. So take a pause, affirm your worth and protect your peace. Bumble helps you create safe, meaningful connections, the kind that truly respect your boundaries, your energy and your time. Thinking about dating again? Take this as your sign. Start your love story on Bumblebee. Many of us play lots of different roles in life partner, employee, caregiver. And many of us also think about another role that could take our life where we wanted to be. Degree holder. That's where National University comes in. They've been busy since 1971 creating more ways for you to work, earning a degree into your hectic life. NU confers more graduate degrees to diverse populations than any other institution in the country, with more than half being earned by women with flexible online formats, NU makes higher education possible and achievable for busy working adults. Learn more today at nu.edu. this episode of Therapy for Black Girls is brought to you by Chase Sapphire Reserve Whether you're booking your next trip or a weekend escape, Chase Sapphire Reserve is your gateway to the world's most captivating destinations. When I travel somewhere, I'm typically determined to try the best local pizza and find the best spa experience. With Chase Sapphire Reserve, you have access to everything from private dinners hosted by award winning chefs to VIP treatment at the most sought after events. Chase Sapphire Reserve allows you to take advantage of one of a kind experiences while earning three times points on dining worldwide. No matter your destination, travel is more rewarding with Chase Sapphire Reserve. Discover more with Chase sapphire reserve@chase.com Sapphire Reserve cards issued by JP Morgan Chase Bank NA member FDIC subject to credit approval terms apply Life's messy We're talking spills, stains, pets and kids.

D (27:38)

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B (28:36)

I want to ask you a question around what feels like empathy and like other people's reactions to people who have been diagnosed with a personality disorder. And we know it's because this cluster of disorders like it, it mostly impacts other people, right? Like it shows up a lot in your relationships. And so there's a lot of burned bridges, a lot of just a lot of hurt that has typically been caused because maybe this person either doesn't recognize they have a personality disorder or because that is the way the disorder itself presents.

A (29:05)

So can you talk about like what.

B (29:06)

Does the support system look like and maybe like what does it mean to have empathy towards people who have been.

A (29:13)

Diagnosed with personality disorders?

C (29:15)

That is a real tough one because I think it takes a certain amount of it takes a lot of patience for people close to a person with a personality disorder to hang in there and not want to reject them. And on the one hand there's the issue of, well, what about the needs of the loved one? I'll just use a personal example. I dated someone years ago and that person did have insight because that person, he had been in therapy. And so me being the empathic person, I was like, oh, he just needs to be loved. I can love him enough. That'll help him heal. Well, okay, that's nice, but what's that doing for me? Like, I'm sacrificing my own self while I kind of put up with being beat up on by this person. So I've got to have my own boundaries as the person who cares about the person with the personality disorder. I've got to have boundaries around how much of myself I'm willing and my own wishes and needs I'm willing to put aside for the sake of. Of just tolerating bad behavior, if you will, from this other person while still trying to be understanding that they're working through something. Now, I think the difference is if the person really is working through, they're at that stage of having very little awareness or very. They may be aware because they've watched a bunch of TikTok videos, but they're still not wanting to get into any kind of treatment because it's not that bad. They don't need to go pay somebody for this. They can work on this. Well, the working that they're doing is attacking you every day and trying not to attack you. I mean, so. And that's not really going to help very much. The call to be patient and make the sacrifice of putting up with the stuff comes if the person is actively working toward change because you need to give them credit for that. But it's not a good situation if the person hardly recognizes that they. They need to change. Another part about this too is, well, what about you? In retrospect, I can see. I mean, I was much younger then, but I could see where I was part of the problem of even allowing myself to be in that kind of relationship. It may not have stemmed from a personality disorder, but it stemmed from some vulnerabilities I had that allowed me to just deal with whatever I was getting all that to say. Be careful not to judge the other person too much because you're probably not 100% yourself. And so they're probably putting up with some stuff from you. So that's another kind of concession you can give them that if they're working toward change, they're going to need a long Runway to be able to make those changes. But you also got to have to look at Yourself too, and not just be standing on a high horse saying you've got a personality disorder, nothing's wrong with me, you need to fix yourself or I'm gone.

A (32:38)

Dr. Marks, are there any like racial.

B (32:40)

Or cultural nuances that are related to like the diagnosis of personality disorders that you feel like are important to call attention to?

C (32:50)

That's a really difficult question for me to pinpoint, like give a specific answer. The way that we have defined personality disorders already has a lot of criticism associated with it. In fact, in the DSM there's a whole like appendix area of a whole nother way to, to look at personality disorders. And because it's, you know, this is thought that this is kind of, this is old fashioned and it doesn't really take into account nuances. And I think the nuances come with the cultural differences. So I think it's very easy for say a black male to be considered antisocial if he's the least bit. I don't even say aggressive because I think that's another bias. But the least bit assertive. Loud talking, arguing for the sake of arguing. I mean things that you're used to in your family. Someone looking from the outside could say, oh, all these people have personality disorders. And I think it's easy to peg people as if you're the least bit disagreeable, if you will, then you're angry. That's not necessarily calling someone personality disordered, but it still speaks to that easily pathologizing behavior because it's something that you're not used to. But another kind of cultural bias is the one of or stereotype is the Italians living next to you arguing all the time. Well, people can say that about black people too, but, but that idea of people talking loud or having disagreements, that's pathology. Whereas that actually may be adaptive for that group of people. Like being able to just be frank about what you're feeling. That's a good thing rather than stuffing your feelings because we're going to look a certain way and growing up believing that it's not okay to express yourself, that causes problems.

A (34:57)

Thank you for that.

B (34:58)

That nuance. I think that's helpful. So you know, you've made a couple of comments that I definitely want to talk more about in terms of all of the mental health information that we're seeing online, all of the information that we see in YouTube, TikTok, like all of the places. And I would imagine your training was similar in that I was trained that the number of people who actually meet criteria for personality disorders is very small. If you go online, oh my gosh, like, it's one in three. Like, there are. Everybody has a personality disord. Can you talk a little bit about, like, the proliferation of conversations around mental health, specifically around personality disorders and what you think is often missed in some of these conversations?

C (35:39)

Yes, I'm trying to hold it together. I can't not go off of my soapbox.

B (35:47)

But that's a welcome here.

C (35:50)

Okay, so I want to just. Let me just cut to the chase. I cannot stand the way narcissism is portrayed online. I can't stand it. Granted, there are people who put out very accurate and helpful information, but somehow, because it's become trending such that people have just latched onto it and turned any thing that they don't like about someone into. It's because of narcissism. You know, everybody's mother isn't a narcissist. So I'm not actually sure why we've latched onto that personality disorder. I'm not sure. But that has become the scapegoat for any bad behaviors because you're a narcissist. And this is a small antidote. Example, my son, he was in middle school at the time, and I was. He's got social anxiety, and I was trying to help him with, like, how to have conversations with people. And so I was saying, okay, so you know, you. And you need to ask people questions and listen and then try and follow up on some of those questions later of. Of things that they told you. And then you also want to give a little of yourself too. So you don't want to just be an interview. You want to talk about yourself. Give an example you had in your life. And he said, yeah, but if I talk about myself, then I'm being a narcissist. And I thought, oh, my goodness, really? Is that what we've come to? And so I think narcissistic personality is a lot more complicated or complex than we give it credit for online. There's different presentations of it, but narcissism itself is a good thing. In fact, not having a healthy love of yourself is what makes you susceptible to. To narcissistic personality disorder, because you have either a fragile sense of self or an overinflated sense of self stemming from not enough self validation. So you're more sensitive to slights and things or needing to puff yourself up or tear people down to build yourself up and things like that. All right, so that's my soapbox sorry on that particular disorder. But I think that just As I was saying earlier that even in a diagnostic setting, we psychiatrists or psychologists, clinicians, are trained to put the brakes on any tendency to want to diagnose someone with a personality disorder on the first meeting, especially if it's in the context of them having what we would call an Axis 1 disorder. Those would be the things like depression, bipolar disorder, anxiety, ocd, things like that. Because that's like the storm that can cover up the personality that's underneath. You can't really see what's underneath if you've got all this other stuff going on. So if a clinician can't always know what an underlying personality is, someone has doing a diagnostic evaluation, how can you watch a TikTok video and know what someone's personality is? And it's not useful too, because unfortunately I think it ends up being used as weapons for name calling and boxing people in. And that's not the intent, you know, of even having this, this construct of personality disorders. So on the positive side, I am pleased with how far we've come in talking about mental health in general. When I started on YouTube, actually, I started probably like 2010, and I had had several false starts because people didn't, at least from the comments I got, people didn't want to hear about this. And so I got a lot of lot, a lot of hate. So I just, I put out a few videos, then get scared and stop. So anyway, when I started in 2018, regularly, even then, like, part of my purpose was to destigmatize the discussion and a goal was to make talking about mental health part of regular conversation. Not anything that we got to whisper about. We're not all the way there, but we're pretty far along. And I love that. I love that a Gen Z person can say out loud, well, my anxiety is getting in the way of me doing xyz. And I can admit that and not feel ashamed. But with every good thing comes downsides too. And this is just one of those downsides of proliferation, of misinformation, but also the trivialization of some of these disorders, such that ADHD is another one that not every trouble. You know, I couldn't focus yesterday, oh, I've got adhd. Not everyone who has trouble focusing has adhd. But, you know, I think it's just human nature to want to put people in categories, name things, understand what things are. And so I can't fault someone who has limited information to take the information that they do have and try and apply it. And that's essentially what's happening.

A (41:35)

More from our conversation after the break. These days, most things cost an arm and a leg, especially vacations. But not in Rhode Island. Between affordable luxury stays, succulent seafood right from the source, and spectacular shopping that won't break the bank, you get a real bang for your buck in the Ocean State. The memories will be priceless, but the cost will be a lot less. Rhode Island.

B (42:05)

All that.

A (42:06)

Plan your trip today@visitroadisland.com that's visit Rhode Island.com okay friends, real talk. You are worth the wait. We've all been there, giving our energy to connections that didn't honor ours and watching friends do the same. And honestly, we all deserve better. That's why Bumble is built for intentional dating. Safety is such a big deal for us all, especially when meeting new people. And Bumble gives you the peace of mind with options like photo and ID verification. That little extra step means you know the person you're talking to is who they say they are with their real photos and they are ready to show up authentically. And once you feel safe, you can actually focus on what matters. Finding someone who gets you with shared interests. It's easy to see right away who vibes with your passions, whether that's true crime, podcasts, yoga mornings or weekend hikes. So take a pause, affirm your worth, and protect your peace. Bumble helps you create safe, meaningful connections, the kind that truly respect your boundaries, your energy and your time. Thinking about dating again? Take this as your sign. Start your love story on Bumble. Many of us play lots of different roles in life partner, employee, caregiver. And many of us also think about another role that could take our life where we want it to be. Degree holder that's where National University comes in. They've been busy since 1971 creating more ways for you to work, earning a degree into your hectic life. NU confers more graduate degrees to diverse populations than any other institution in the country, with more than half being earned by women with flexible online formats, NU makes higher education possible and achievable for busy working adults. Learn more today at nu.edu. this episode of Therapy for Black Girls is brought to you by Chase Sapphire Reserve. Whether you're booking your next trip or a weekend escape, Chase Sapphire Reserve is your gateway to the world's most captivating destinations. When I travel somewhere, I'm typically determined to try the best local pizza and find the best spa experience. With Chase Sapphire Reserve, you have access to everything from private dinners hosted by award winning chefs to VIP treatment at the most sought after events. Chase Sapphire Reserve allows you to take advantage of one of a kind experiences while earning three times points on dining worldwide. No matter your destination, travel is more rewarding with Chase Sapphire Reserve. Discover more with Chase sapphire reserve@chase.com Sapphire Reserve cards issued by JP Morgan Chase Bank NA member FDIC subject to credit approval terms apply.

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B (45:51)

Of course there's the the YouTubes, the Tik Toks, all the things. But there's also like bigger media productions like movies and TV shows that often don't do the greatest job of actually displaying what a personality disorder might look like? Are there any instances of things in.

A (46:05)

Film or TV that you've seen and.

B (46:07)

You feel like they've done actually a really good job talking about or displaying personality disorders?

C (46:12)

So this isn't personality disorder, but I did really like the way they portrayed psychosis and A Beautiful Mind. Way back in the day with Russell Crowe. That was like my first experience with feeling like, wow, okay, they did a great job of showing this and how it can be. That was very creative of them. But since then there was a movie out that came out not too long ago with Tom Holland and I forget the name of it. They were trying to show multiple personality disorder, which is a very complex disorder. And I just thought, I mean, I don't know, I think there's more examples of it just being this is what we need to see on screen. This is what will excite people. So let's make it look like this than true portrayals. Because true portrayals aren't necessarily all that Interesting.

B (47:12)

Yeah. Which I think is what makes them sometimes difficult to depict online. Right. Or in film and tv.

C (47:18)

Yeah, yeah, exactly. And actually that's a good point. Back to this. Like, why is there so much focus on, say, narcissistic personality disorder and borderline. They're in the cluster of dramatic. And dramatic is more interesting than anxious, like a dependent personality disorder. That's not as interesting. So, yeah, that the presentation itself, I think does have something to do with what's portrayed, how it's portrayed, and how much we focus on it.

A (47:50)

Dr. Marks, what suggestions would you have.

B (47:52)

For people for wading through all of the information they might find online? You just mentioned, like, of course people want resources. Like, something's happening. I want some answers. What suggestions do you have for people for how to make sense of what they might find online?

C (48:05)

Yeah, so I guess first is getting clear on what you're trying to accomplish. So there's watching for entertainment like we do television, and then there is trying to get insight about yourself, and then there's trying to get insight about someone. You know, I think if you really are trying to understand yourself better, it's about looking at the source and being aware of things being too generalized. So I can think of an example, a TikTok video. I saw someone. I can't remember exactly what she said. It was something like signs of my adhd. And it was, I can't stop writing in my journal or something like that. Where it's like, that's actually. I mean, people can have do that for any reason. That's not. That doesn't equate to. Well, then you've got ADHD if you do these things. But that's what people will take from that. So the viewer then has to be aware that. To keep in mind that people talking about their personal experiences is their personal experiences. And it's not necessarily something you can draw from. You might be able to relate that. Oh, yeah, I do that too. But that doesn't mean you now have a disorder because of that. And so I think if there's a lot of things you can get online, and I think that the things to get to extract out of all of the information online is feeling the things that you're experiencing. Well, that you're not alone, but then that you're feeling heard, like, wow, she does this too. Or she has this too. This is what. Okay, I don't feel so bad anymore. Like, those are some positive outcomes. That still has nothing to do with what your diagnosis is. That's just experiences and so this unification of experiences and destigmatizing and all that, those are all good things that I think are good to get from social media information. Going deeper than that though, as far as actually feeling like it's helping you understand yourself or even come to a conclusion about something you may have. Looking at the source. So YouTube has taken the step of identifying clinicians and putting that label under their videos. So we have to submit our licenses and things like that. So all of my videos will say this is from a licensed health provider and they do that for this purpose so that people can have a better way of screening the source of their information so that at least you have a greater chance that this is accurate. So looking for reliable sources, accurate sources Even on say TikTok or Instagram, if the person, they don't have those labels like YouTube, but you could still look at their, the person's credentials. So pay attention to whether what you're watching is someone's personal experience, which may not apply to you and others, or is it from a clinician talking about broad experiences and talking more in specific terms. Then if you think that you have a disorder, go get a second opinion or an official opinion from a licensed clinician rather than just going with that and trying to find a way to treat yourself if it's something that requires some form of treatment. Because let's just say we're talking about personality disorders today. But let's say you watch a bunch of videos and you believe that you have, I don't know, dependent personality disorder, which is in the anxious fearful cluster where you are very hesitant to be assertive. You feel like you need people to take care of you a lot, which can cause problems getting on people's nerves or just not being able to have enough get up and go and do your own thing because you've got to wait for other people's approval. If you recognize that because of some videos that you've seen, then you know it's still helpful for you to have that insight. Going back to what I was saying earlier about often with personality disorders people lack the insight to see what the problem is. So it's still a win if you never see a psychiatrist or therapist. It's still a win to have insight. So if these videos help you have insight, that's good, but still it's good if then you can take it to the next step and try and work on yourself. There's books, there's lots of self help material out there that's written and provided by authoritative sources. So you can go to that next step to an authoritative step source to try and get some self help rather than the self help being all from TikTok videos from Jane Doe, who's talking about her personal experience, because everything about her may not apply to you.

B (53:08)

I appreciate you bringing up the idea of resources. And that was my next question. Are there any particular resources like podcasts, books, other things that you typically recommend for people who either have been diagnosed.

A (53:19)

With a personality disorder or people who.

B (53:21)

Who may be in their support system who want to learn more or get more information?

C (53:25)

I don't have anything specific because there's so many things out there now. Years ago, no, but now there's lots of different podcasts. There's your podcast, I mean, which, you know, it didn't exist years ago. So I think it's important though, for people to feel like whatever resources they're using, whether it be a book, a podcast, a YouTube channel, that it feel relatable to them because there's people who've produced some great stuff. But it's, it's either just too academic maybe, and it's just not going to be helpful. So. Okay, don't worry about that. Don't stress over that. There's so many other sources out there, but it really boils down to just doing searches on whatever platform it is that you like to consume, whether it be a podcast. Go to Spotify or Apple Podcasts and search for the topic. Amazon search for the topic. So, yeah, I don't have a specific recommendation because there's just so many resources out there. Oh, one other thing though, so getting more specific about resources. So. Nami, national association of Mentally Ill. Don't let that ill word scare you away. But before there was so much more information like podcasts and online information, they were kind of a good place to go for resources, and they still are. But personality disorder wise, I'm not so sure. I don't know what they have to offer there, but that is still another place you could look.

A (55:07)

What's one thing that you hope people.

B (55:09)

Leave this conversation kind of understanding better about personality disorders?

C (55:13)

Dr. Marks, I would love it if people just understood the basic that we all have personalities and not all personality traits are pathologic like personality disorders. Is pathology, meaning it causes problems in multiple areas of your life. So one bad day, one bad month of you feeling insecure and yelling at people does not mean you have a personality disorder. This is a pattern of behavior that, that, that reaches or affects multiple aspects of your life. Your relationships, your, your work relationships, as well, or school, if you're still a student. It affects even how you feel about yourself. The second part of that is personality disorders are. They're not rare, but they're not common. So let's just say general prevalence rates may be around, let's just say on a high side would be like 5, 6%. Depression is around 10 to 12%. Those are still small numbers in the big scheme of things. But personality disorders is less common than depression. So don't be so quick to believe that every person with bad behavior or who gets on your nerves and you can't stand has a personality disorder. They may be going through some things that's making them act this way. They may have emotional dysregulation, which is not the same as a personality disorder. That's an aspect of your behavior that's controlled by your brain, your prefrontal cortex. Be specific. And so if someone has trouble managing their emotions, it doesn't necessarily mean they have a personality disorder. So not everything, so big picture here, not everything is personality disorder. If you feel you have one or you've been identified to have one, you can change. But you've got to temper your expectations that it's going to be a little bit of change over time. And you've got to be patient with yourself or patient with the person in your life who is working on themselves. Because just like your personality did not form from one thing, the, the solution to it or the change doesn't happen from a couple of things you do. It's going to be a lifetime of change.

B (57:55)

And where can we stay connected with you, Dr. Marks? Where can we check out the YouTube channel and anything else you have to offer?

C (58:01)

Sure. So my main platform that I am active on is YouTube and my channel is my name, Dr. Tracy Marks. And that's D R and then T R A C E Y and then M A R K S. The same handle on Instagram and the same handle on. On TikTok as well. But I'm more active on YouTube and then Instagram and then TikTok last. My website where I just, I post articles and also my videos on that site as well is markspsychiatry.com perfect.

B (58:38)

We'll be sure to include all of that in our show notes. Thank you so much for joining us today, Dr. Marks. I appreciate it.

C (58:44)

You are so welcome. I enjoyed this and thanks for having me.

A (58:47)

Thank you. I'm so glad Dr. Marks was able to share her expertise for this conversation. To learn more about her and her work, visit the show notes@thristyforblackgirls.com session431 and don't forget to text this episode to two of your girls right now and tell them to check it out. Did you know that you could leave us a voicemail with your questions or suggestions for the podcast? If you have movies or books you'd like us to review or have thoughts about topics you'd like us to discuss, drop us a message at Memo FM Therapy for Black Girls and let us know what's on your mind. We just might feature it on the podcast. If you're looking for a therapist in your area, visit our therapist directory@therapyforblackgirls.com directory. Don't forget to follow us on Instagram at Therapy for Black Girls or join us over in our Patreon channel for exclusive updates and and behind the scenes content. You can join us at Community therapy for black girls.com this episode was produced by Elise Ellis, Inde Chubu and Tyre Rush. Editing was done by Dennison Bradford. Thank y' all so much for joining me again this week. I look forward to continuing this conversation with you all real soon. Take good care these days most things cost an arm and a leg, especially vacations. But not in Rhode Island. Between affordable luxury stays, succulent seafood right from the source, and spectacular shopping that won't break the bank, you get a real bang for your buck in the Ocean State. The memories will be priceless, but the cost will be a lot less. Rhode Island all that, plan your trip today at visit rhode island.com that's visit rhode island.com Many of us play lots of different roles in life partner, employee, caregiver. And many of us also think about another role that could take our life where we want it to be. Degree Holder. That's where National University comes in. They've been busy since 1971 creating more ways for you to work earning a degree into your hectic life. NU confers more graduate degrees to diverse populations than any other institution in the country, with more than half being earned by women. With flexible online formats, NU makes higher education possible and achievable for busy working adults. Learn more today at nu.edu. this episode of Therapy for Black Girls is brought to you by Chase Sapphire Reserve. Whether you are booking your next trip or a weekend escape, Chase Sapphire Reserve is your gateway to the world's most captivating destinations. When you use your Chase Sapphire Reserve card, you get eight times points on all purchases made through Chase Travel and even access to one of a kind experiences like music festivals and sports events. And that's not even mentioning how the card gets you into the Sapphire Lounge by the club at select airports nationwide. Travel is more rewarding with Chase Sapphire Reserve. Trust me. Discover more@chase.com Sapphire Reserve cards issued by JP Morgan Chase Bank NA member FDIC subject to credit approval terms apply. This is an iHeart podcast.