For all its widespread use, methylphenidate—sold under names like Ritalin, Concerta, and Medikinet—still carries a few surprises.

One of them? It might only curb impulsive decision-making in men.

A recent neuroimaging study out of the University of Haifa, published in NeuroImage, offers a startlingly specific twist: a single 20 mg dose of methylphenidate reduced “choice impulsivity” in men, but had no such effect in women. The reason, researchers suspect, lies deep in the brain’s white matter highways—particularly in a region called the forceps major of the corpus callosum.

Let’s unpack that.

What Exactly Is Choice Impulsivity?

Picture this: You're in your 40s or 50s, carrying a bit more belly than you’d like, feeling persistently low, and not having much sex—maybe less than once a month.

That’s another pretty common American snapshot.

Now imagine this trifecta—low sexual frequency, depression, and abdominal obesity—as a subtle but powerful predictor of early death.

According to a 2025 study published in the Journal of Affective Disorders, this exact combo may quietly and cumulatively shorten your life, especially if you're a man (Teng et al., 2025).

This isn't moral panic or pop psych clickbait. It’s epidemiology. And the numbers are quietly devastating.

Let’s get this out of the way early: FWB stands for Friends with Benefits, not Free With Burrito, though both can lead to regret and gastrointestinal confusion.

But what exactly is a friends-with-benefits relationship?

A quick gloss might say: “Two people having sex without the commitment of dating.”

But that’s like saying jazz is just music without words—it misses the improvisation, the ambiguity, and the occasional heartbreak hidden behind the snare drum.

In America, the “FWB” arrangement has become a full-blown cultural meme—a relationship archetype circulated in media, music, TikTok therapy, and private texts at 11:48 p.m. on a Wednesday. But what does it mean, socially and psychologically?

Is it a healthy middle ground between celibacy and codependence—or a slow-motion emotional trainwreck?

Let’s take a walk through the recent research, the cultural history, and the messy inner logic of FWB, in all its contradictory American glory. Don’t worry—I’ll be gentle.

If porn-induced dissociation had a mascot, it would be the glassy-eyed man in front of six screens, edging into oblivion.

His jaw slack. His dopamine hijacked. His browser history a Dantean archive of algorithmic seduction.

This is not just porn addiction.

This is gooning.

And it’s quietly becoming the most extreme expression of compulsive masturbation in the digital era.

Once upon a time, puberty blockers were used to delay puberty in eight-year-olds with a pituitary problem. Testosterone was for men in midlife crisis.

Surgeons would not remove healthy breasts unless they were asked very nicely by an oncologist.

Then, for reasons both noble and tragically naïve, we rewrote those rules.

We called it progress.

And for some, it was. For others, it was a detour into a medical maze with no exit and no map.

This isn’t about whether transgender people deserve care. They do.

The question is whether we’re giving them good care—or just fast care with bad evidence and even worse incentives.

You know the type. Your boss grins like a Bond villain, praises you with the same tone he uses to order decaf, and has mastered the dark art of dodging accountability while somehow basking in your accomplishments.

He’s not charming. He’s not ethical. He might not even know your last name.

But he’s climbing the ladder—and you’re left wondering what universe this HR department lives in.

Welcome to the strange world of Machiavellian leadership. Where manipulation wears a nametag, and your office feels more like a Game of Thrones prequel than a team meeting.

What Is a Machiavellian Leader?

There’s a new buzzword slipping into couples therapy circles: microdosing conflict.

Borrowed from the language of psychedelics and exposure therapy, this meme encourages couples to engage in small, controlled doses of interpersonal tension.

The goal? Build resilience without flooding the nervous system.

Rather than the traditional model of “Let’s sit down and hash this out for 45 minutes,” microdosing conflict says: try five.

Bring up a frustration with intention, stay present for just a few minutes, then step away before anyone spirals. Repeat as needed. It’s therapy in tapas form.

There’s a growing trend in couples therapy that highlights a subtle but powerful dynamic eroding intimacy: emotional triangulation.

Not the classic love triangle or secret affair, but the kind of triangulation that enters quietly through work, children, digital distractions, or even grief.

This emotional third isn’t a person.

It’s a force that takes up space in the relationship—drawing attention, emotional energy, and connection away from the couple.

Think: the demanding job that becomes a silent spouse, the child who mediates all communication, the phone that receives more eye contact than your partner.

Even therapy itself can become a third, deflecting intimacy rather than fostering it.

Once upon a time in the land of couples therapy, two tribes staked out opposite hills.

On one hill stood the Attachment People, holding up a sign that read: “Safety first. Then everything else.”

They believed relationships should be a haven—soft landings, secure bases, nervous systems synchronized like a duet.

On the other hill stood the Differentiation Folks, their banner flapping in the wind: “Grow up. Don’t lose yourself just because you’re in love.”

These were the disciples of David Schnarch, preaching self-definition, holding still while your beloved has a meltdown, and not chasing them through the house just because they’re withdrawing.

And for a long time, it seemed, therapists had to pick a hill.

But now, in a plot twist that would please both evolutionary biologists and couples therapists with a sense of humor, we’re watching a merger.

It starts with a scribble.

A simple line. Maybe a circle. Then a box with the word “shutdown” inside it, and a sad little arrow pointing to a stick figure sulking under a weighted blanket.

Congratulations. You’ve just begun the ancient, noble, and wildly underrated practice of therapeutic mapping.

If you’re a therapist working with neurodiverse couples—or a neurodiverse human trying to love another human without exploding—you already know this: words are slippery.

Feelings are murky.

And memory? Memory is a drunk historian rewriting your day while you’re still living it.

Enter the map.

Let’s name the system: you live inside a machine designed to keep you emotionally dysregulated—so that you consume more. This isn’t conspiracy.

It’s Limbic Capitalism: the commercialization of your fear, grief, shame, and longing (Schüll, 2012).

When your nervous system is constantly pinged by:

• Ads that whisper you’re not enough

• Influencers who sell “authenticity” like it’s a handbag

• A culture that pathologizes stillness and prizes performance

…your thoughts stop being yours. Cognitive mapping helps take them back.

Neurotypical jealousy is already a mess—emotional leftovers reheated in the microwave of your frontal cortex at 2 a.m.

But neurodivergent jealousy? That’s a four-dimensional chess game played during a fire drill, in a building you’re pretty sure you don’t belong in.

There’s no diagnostic code for it.

No neat little checkbox on the clinical intake form.

But if you look closely—at obsessive loops in autistic rumination, impulsive flares in ADHD relationships, and the strange emotional shape-shifting in people who’ve spent a lifetime masking—you begin to see its contours. Subtle. Searing. Sometimes silent. But undeniably real.

Let’s walk through it. Carefully. Kindly. And maybe, if we’re lucky, insightfully.