What Makes Something a Disorder? with Dr. Lori Butts | EDB 267

 

Psychologist, attorney, and Different Brains board member Dr. Lori Butts shares what makes something a “disorder”.

(VIDEO – 23 mins) Dr. Lori J. Butts is the CEO and President of the Clinical & Forensic Institute (CFI) with offices in Fort Lauderdale and West Palm Beach, Florida. After graduating from Clemson University with Honors, Dr. Butts received her law and doctoral psychology degrees from the innovative jointly sponsored program by Villanova School of Law and MCP Hahnemann University Department of Clinical Psychology.  Dr. Butts completed her internship in clinical and forensic psychology at New York University School of Medicine, Bellevue Hospital, and Kirby Forensic Psychiatric Hospital, She fulfilled her residency requirements at CFI where she was trained by Dr. John A. Spencer.  Dr. Butts is licensed to practice psychology in Colorado and Florida and is a member of the Florida Bar.

Dr. Butts is the Past President of the Florida Psychological Association (FPA). She has previously served as the President of the Forensic Division of FPA and the Co-Chair of Legislative Affairs and Public Policy Board. Dr. Butts has also served on the Committee on Legal Issues (COLI) for the American Psychological Association. She has received the “What A Woman Award” and has been recognized as a Distinguished Psychologist for her dedication and service to the profession of psychology by the Florida Psychological Association. In 2016, she was recognized as the “Mental Health Professional of the Year” by the Broward County Crime Commission.

To find out more about Dr. Butts’ work, visit https://cfiexperts.com/ 

 

 

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FULL TRANSCRIPTION


 

DR HACKIE REITMAN (HR): 

Hi, I’m Dr. Hackie Reitman. Welcome to another episode of Exploring Different Brains. And today we’re honored to have Dr. Lori Butts. Not only is Dr. Lori Butts, that great forensic psychologist. Not only is she an attorney, not only is she the past president of every kind of organization you can think of to do with psychology and law and forensics, but she’s also a board member of Different Brains. Welcome, Dr. Lori Butts.

 

DR LORI BUTTS (LB): 

Thank you Hackie, always enjoy being here.

 

HR: 

Now why don’t you introduce yourself to the audience properly, because they don’t know you like I know you’ve arrived to us.

 

LB: 

I can’t do it any better than you just did. I’m an attorney and a psychologist. I practice mainly as a forensic and clinical psychologist, which means I help people and I also do evaluations for courts.

 

HR: 

I thought what might be cool is to have you for us do something that confuses me greatly. I want to discuss things that make something a disorder, as opposed to just “eh, something”. Can you define for the audience: what is the disorder in your mind?

 

LB: 

Well, it’s not in my mind, it’s in diagnostic books. So in order to be a disorder, it, there has to be an impairment in functioning. So and that’s important, because I think the more people get educated about mental health issues and things like that people throw around things like, Oh, I have this, the one that I hear the most, I think is, oh, I’ve got OCD. And I hear that all the time. And, and because somebody’s organized does not mean they actually have a disorder. Because people like something a certain way, and that doesn’t mean it’s a disorder, that means that they may have, you know, or anywhere, you know, we talk about a spectrum, right, so on a spectrum of, of things, it only becomes a disorder, when it’s an impairment in functioning. It’s an it’s negatively impacting someone’s life, to be highly organized, is not necessarily an impairment. It’s actually adaptive and helpful, especially in certain kinds of careers and certain kinds of, you know, busy people, it actually is very adaptive, where it becomes maladaptive and problematic, that’s when it starts getting close to being a disorder.

 

HR: 

Very interesting. It’s kind of like when I was in medical school 100 years ago, that the definition of an alcoholic was somebody who had to miss work, mess up their lives and stuff like that, as opposed to by how much they drink. You and I both know, some people who drink a lot and they function very well.

 

LB: 

Correct. Correct. And that’s, you know, we colloquially call a functioning alcoholic, right? So, so again, it all depends, it depends on if it’s interfering in it, you know, some people work in the alcohol business, and so drinking more than normal person is part of their job description. So it becomes very murky in those situations, and where’s impairment.

 

HR: 

Getting back to your example of let’s use the example used OCD, okay. I want to know, if you believe in what I do, which is using OCD, I don’t know anybody who’s a champion at anything. Who does not have what I call and it might be a misnomer. And you can straighten me out if it is I call they have OCD traits that help them do what they do. But it’s not a disorder. It’s just…

 

LB: 

And people have traits of all kinds of personality disorders, and people have traits of all kinds of different things. And certainly, I don’t, you know, depending on the situation, I don’t think that’s an appropriate. I think that’s a way to communicate, that people can agree upon, like when you say you’ve got OCD traits, I think everyone kind of understands — it’s a shorthand. Everyone knows what you’re talking about somebody that’s highly organized, you know, they’re detail oriented, things like that. So it’s a shortcut to explain. How you see that person is high functioning in an organized fashion. I wish that I had those traits. I’d probably been way more successful. As much as I try.

 

HR: 

What would you say to someone who feels that they need the help of a psychologist, but they’re afraid of the stigma and they’re just afraid to go?

 

LB: 

I would say that psychologist is going to a psychologist is a non-judgmental zone. It’s an a warm environment. You know, talk to, if you’re embarrassed to talk to friends about getting a referral, you know, call a few offices, see what your comfort level is. Obviously, now with telehealth, it’s more accessible, I think for people that are afraid to walk in the office or, or go to a waiting room. And so, you know, check out people’s websites and see, look at people’s backgrounds and understand that, that psychologists want to help, they don’t want to judge they don’t want to do anything negative. But But and you don’t have to be in therapy forever. And if you go to somebody you don’t like them, you can go someplace else to if you don’t have a good feel for them. So you’re in control of the situation. And a lot of people are struggling, and it’s a, it’s a great space, to just focus on yourself, and just do something positive for yourself, whether it’s for one hour, or whether it’s 10 hours, you know, just just do one thing for yourself, it’s an hour out of your life. And hopefully, you’ll realize that it’s going to be something that’s helpful and beneficial for you.

 

HR: 

What would you say to someone who might be afraid of getting a diagnosis, and they’re apprehensive? What would you tell them?

 

LB: 

I think, I think most, you know, unfortunately, the insurance is really the driver of the diagnosis. And most psychologists that I know, it’s not about the diagnosis, it’s about the issues that are presenting themselves and how those issues are impacting someone’s life. So it’s about it’s about resolving problems and help helping somebody cope better or problem solve better, feel better. And it’s it’s not about the diagnosis, because the diagnosis is is pretty tangential to what’s actually happening. But unfortunately, the way you know, the model is is insurance based reimbursement on a diagnosis.

 

HR: 

What has changed in your world, and in the world of mental health with this onset of COVID?

 

LB: 

So much has changed. I do all of my evaluations and therapy sessions remotely now. And it the Access to care is really increased. Because, you know, in South Florida, transportation is a big issue. And so it’s cut out the transportation, the drivetime that barrier. And, and people are comfortable in their homes, and they’re actually more comfortable to talk about personal things from the setting of their own home. As opposed to sitting in a room in an office someplace. Especially younger, the younger generation people. They do everything online. And and so it’s just kind of melding into people’s lives much easier. And more, like I said, more accessibility. And and I think, you know, there’s a piece that gets lost being in the room, but I think I’m biased, I think that that the accessibility portion of it outweighs that. There are other people that would disagree and and everybody’s different. There’s a lot of people that would prefer to come in person and feel like it’s more focused and less distractions and you can open up more. But then there’s some people that are more comfortable. So it’s giving more opportunities for people to get access to care. So it’s I think it’s great.

 

HR: 

Your profession, what was the biggest thrills that you’ve ever had in your work?

 

LB: 

The biggest thrill I’ve ever had my work is seeing somebody who somebody succeed and and so I deal with a lot of clients that have a high risk backgrounds have committed serious crimes, and people that actually succeed and move past that and have happy, positive, productive lives. That’s, that’s beyond rewarding and thrilling for me.

 

HR: 

We are so lucky here at Different Brains that you are the co host of our audio podcast focused on autistic women: Spectrumly Speaking along with the wonderful self advocate Haley Moss, who’s does it all. How is that been for you so far?

 

LB: 

It’s been great. It’s been such a wonderful experience. Haley’s enthusiasm is just inspiring. And she’s just, she’s so eager to learn and the people that we interview are, have so much to contribute. And they just open up my mind to so many wonderful areas that are, you know, not usually on on my radar in my everyday life, and they just really… And I probably sound like a broken record during our podcast, because every week I’m I’m impressed with whoever we’re speaking to. They’re just amazing people. It’s just, it’s wonderful.

 

HR: 

What’s one thing you’ve learned by doing a podcast?

 

LB: 

To not listen to myself afterwards. I laugh way too much.

 

HR: 

I think it’s part of your charm. Let’s talk a little bit about who your great your greatest mentors have been in your career. Who comes to mind?

 

LB: 

John Spencer.

 

HR: 

John Spencer, my friend, John Spencer, may he rest in peace.

 

LB: 

Yes.

 

HR: 

Tell us what made him so special in the field of forensic psychology.

 

LB: 

Yeah, it’s just so brilliantly smart. He could read, read a person read a transcript, read a psychological test, and make it understandable and see all the nuances in whatever, you know, stimuli we’re talking about, and be able to process it and remember it. And, and then articulate why that was an important piece. So being a forensic psychologist, you have to really look at the details. And the other piece is, his ability to story-tell was I just, I don’t, another trait I do not have. And so he could tell a story, and convey sometimes very complex, distill complex information, tell a story and make it completely understandable. And it was just, I mean, remarkable on a daily basis.

 

HR: 

Was a remarkable, remarkable guy. Yeah, sure. And helped a lot of people. What would you say to someone in our audience who’s thinking of going into the field of psychology, or the field of law, or combining them as you have in the field of forensic psychology? What would you tell them?

 

LB: 

I would tell them before they embark on such a long educational, expensive endeavor, to really shadow somebody, follow someone to see what it’s really like on a day to day basis, because it’s a big investment, financially, timewise, and if you come out on the other side, and it’s something that you’re, you know, you realize you didn’t want to do or there was a part about it, that wasn’t interesting. And maybe you should have done something else. You’re already way down that track and that’s not a good place to be in down that career path. Once you’ve done all that investment. So definitely mentors shadow, different people doing different things, different aspects of what you’re interested in. And that way you can really say, No, that’s not for me or yes, that’s exactly what I’m committed to. And that’s what I want to do and, and be focused and driven to reach that goal.

 

HR: 

Great advice. Always shadow, if you can. I remember there was one young woman was graduating high school and going into college and her whole she was at the Hackie Reitman Boys and Girls Club. And she her whole life she wanted to become a surgeon. And she told that to us down at the Boys and Girls Club, and I said, Well, why don’t you shadow somebody to see what it’s really like? And she said, Could I shadow you? I said, Well, I’m an orthopedic surgeon, but you can. And she shadowed me for a couple of weeks. And when she was awarded a scholarship to go off to college that she earned at the Boys and Girls Club, when she was giving her acceptance speech. She said, I especially want to thank Dr. Reitman, because my whole life, I wanted to become a surgeon, and I shadowed him for two weeks. And I’m going to be enrolled at FSU, in criminology. And it was great because she didn’t want to be a doctor, it sounded cool, right? When you go down that path of pre med and everything else, oh my god, it’s a 15 year investment. You don’t want to do, right, when I both know people who got into careers that they don’t like, right? As we tell our wonderful neurodivergent interns here at different brains find something you like, I will help you find something new, like get some exposure, shadow people in different areas. Can you talk a little bit about how your experience has been as a mentor, and board member here at Different Brains?

 

LB: 

Sure, it’s been amazing. Again, the inspiration it’s my area of my my professional life that brings me the most inspiration. Because it’s just — what these interns and and what the organization is doing to help people it’s it’s, it’s just inspirational, I can’t think of another word a better word. To see the progress to see the the different diverse products that the interns create and their creativity and their commitment and how they go from, you know, having communication problems or socialization problems to just blossoming, it’s, it’s, it’s out of this world, it’s wonderful. It’s really wonderful.

 

HR: 

And they’re all smarter than me and I feel he has seen them. And we’ve got we’ve got one in medical school two are gonna go to medical school, one work and as an EMT, everybody’s going on to bigger and better things. But the important thing is, is that they’re, they’re getting their confidence in this world. And and confidence is very underrated. And a lot of times there’s nobody at home to give them the pat on the back. They don’t happen to have the teacher like you and I may have had who encouraged you, right said you can do this. Unlike my high school advisor, who told me, You’re never going to get a three to six year medical program, you got expelled in a first grade, you got expelled in the tenth grade. Pick something else. Lucky for me, what was it like being at what we were able to do as a past president of the Florida Psychological Association?

 

LB: 

It was challenging, there was a lot of transitions in the organization during the time during my tenure, and it was a it was implementing a lot of changes, transitions, setting a course for more financial stability, more organizational stability, and moving it forward. So it was it was a pretty challenging experience rewarding, very rewarding, but challenging and that we it was at a crossroads time for the organization. And now every you know, we’re doing great, and there’s a lot of advocacy that the Florida Psychological Association does. And it requires, you know, psychologists across the state to be active and to help in lobbying efforts where different different legislative policies are being made that impact mental health issues or the practice of psychology. And so we’re at the forefront of that in in the state and that’s a big undertaking.

 

HR: 

It’s very well said, for those in our audience who might be interested in a career path. Let me just recite some of the educational pathways that you embarked upon to become a psychologist and an attorney. After graduating from Clemson University with honors, Dr. Butt received her law and doctoral psychology degrees from the innovative jointly sponsored program by Villanova School of Law in MCP Hahnemann University Department of Clinical Psychology. Dr. Butts completed her internship in clinical and forensic psychology at New York University School of Medicine, Bellevue Hospital, and Kirby forensic psychiatric hospital. She fulfilled her residency requirements at CFR where she was trained by the aforementioned Dr. John A Spencer, may he rest in peace, a great teacher and a great mentor.

 

LB: 

And a great friend

 

HR: 

He was, so we’re just letting our audience know not to discourage them. But it’s a big undertaking. Big undertaking and but along the way, you might choose other pathways, we have one intern Sariah, who was going to become a obstetrician gynecologist, but she also wanted to start a family and do other things. And guess what? She’s been accepted into the physician’s assistant program at Nova Southeastern. And she’s gonna save about 10 years and still be able to practice almost as a doctor the way the world is changing. And so that comes back to one of our mentors, Bernie Karcinell always saying to me, what are you trying to accomplish Hackie? Don’t ask me these hard questions. Asked me these hard questions.

 

LB: 

At least once a board meeting.

 

HR: 

Yeah. Well, he had always makes me always makes me think many of our interns have gone on to such such good, such good things along the way. And I want to thank you for all you’ve done to help different brains help our interns help in all the production of the media we do and everything else. It’s been really great. And it’s so kind of you to volunteer to do that. So I thank you.

 

LB: 

Thank you for getting me involved. It’s it’s been an honor. And it’s like I said, it’s though, one piece of my professional life that’s just beyond inspirational. So It’s so heartwarming and, and it’s just everything so positive about it. It’s wonderful.

 

HR: 

Well, Dr. Laurie butts, CEO and President of the clinical and Forensic Institute known as CFI, the psychologist, the attorney, the board member at Different Brains. Thank you so much for being with us today.

 

LB: 

Thank you for having me. Hackie. Always a pleasure.