ARFID in Adults: It's Not Just Picky Eating
ARFID in adults is underdiagnosed and misunderstood. Learn how adult ARFID differs from childhood presentations, why it's not just picky eating, and what treatment looks like.
Brian Nuckols
Licensed professional counselor in Pittsburgh, PA. I work with children, adolescents, adults, and couples across seven clinical areas: child and teen therapy (DBT-A), infidelity and betrayal trauma, eating disorders and ARFID, gambling addiction, couples therapy, neurodivergence, and depth psychology. The common thread is patterns that do not resolve with standard approaches, where evidence-based treatment needs to meet the deeper question of why the pattern exists.
If you're here because something is wrong, you're in the right place.
Areas of Practice
Child & Teen Therapy
DBT-A for adolescents struggling with intense emotions, self-harm, and crisis behaviors. Parent psychoeducation and family skills training.
Neurodivergence & Neuro Affinity
Masking, burnout, sensory processing, and rejection sensitivity. RO-DBT for overcontrol, process-based therapy for individual pattern mapping, and depth work that takes neurodivergent experience seriously.
Eating Disorders & ARFID
Specialized treatment for avoidant/restrictive food intake disorder. CBT-AR, sensory approaches, and family-based work.
Gambling Addiction
Evidence-based treatment that takes gambling seriously as both a neurological condition and a psychological one. Understanding what gambling provides is the beginning of recovery.
Couples Therapy
EFT and depth-oriented couples work for relationships where the same fight keeps happening or one partner is changing in ways the relationship can't accommodate.
Infidelity & Betrayal Trauma
Affair recovery that goes beyond stabilization. Gottman and EFT protocols for the crisis, plus the deeper work of understanding what the affair revealed.
Recent Writing
The Double Empathy Problem: Connection Is a Shared Problem, Not a Personal Failure
The breakdown between neurodivergent and neurotypical people is not a deficit in the neurodivergent person. It is a mismatch between two different ways of processing the social world.
Dreams After Trauma: What Changes and What It Means
Trauma changes dream structure in measurable ways: increased threat imagery, reduced dream ego agency, and repetitive content that ordinary nightmares rarely produce. Understanding these shifts helps distinguish trauma processing from normal dreaming and can mark the early stages of recovery.
The Affair During the Year My Mother Was Dying
An affair during hospice is rarely about the affair partner. It is a nervous system looking for discharge while a body the patient has known her whole life disappears in a rented bed.
The Ego-Syntonic Problem: Why the First Month of Anorexia Treatment Is About Identity, Not Food
Anorexia is ego-syntonic, meaning the restriction feels consistent with who the person is rather than foreign to the self, which is why the first month of treatment has to address identity fusion before behavioral change will hold. Weight restoration without identity work produces a recovery the patient privately refuses even while outwardly complying.
Free Courses
Psychoeducation courses written for the people living with these conditions and their families. Evidence-based, clinician-written, no cost.
Common reasons people reach out
- "My partner had an affair and I don't know how to trust again"
- "My child won't eat and our pediatrician mentioned ARFID"
- "I've lost more money than I can admit to anyone"
- "We love each other but feel like roommates"
- "My teenager is cutting and I don't know what to do"
Free Self-Assessments
Clinician-designed tools to help you understand what you're dealing with. Free, private, no account required.
Assessment
View all assessments → GEAR Assessment
Screens for gambling-related harm across four domains: financial, emotional, relational, and behavioral. About 5 minutes.
Take the assessment → AssessmentPersonal Reflection Inventory
Maps your psychological patterns, including stress responses, interpersonal style, and how you relate to control. About 15 minutes.
Take the assessment → AssessmentCognitive Style Inventory
48-item assessment of eight cognitive processes based on Dario Nardi's research. Best-fit personality type and archetypal function stack. About 5 minutes.
Take the CSI → Assessment SuiteAutism & Neurodivergence
AQ-10 quick screen (5 min), CAT-Q masking assessment (10 min), and RAADS-R comprehensive (20 min). Designed for adults, especially women and late-identified individuals.
See the assessments → AssessmentC.A.R.E. Assessment
Measures four dimensions of relational health: Calm, Accepted, Resonant, and Energized. About 5 minutes.
Take the assessment →