CENTERED PSYCHIATRY™
Kathy J Russeth, MD, SC
drkathy@centeredpsychiatry.org
Ph 608-305-4150 Fax 608-305-8736
345 W Washington Ave, Suite 307 Madison, WI 53703
Understanding High Intellectual Potential and Emotional Intensity
A new lens on complex lives and misunderstood struggles
Introduction: When Intelligence and Emotion Intertwine
Recognizing the Gift in the Struggle: A Space for Bright Minds in Complex Lives
You or your child may have always felt a little different—not just brighter, but more intense, more sensitive, more driven to understand the world in a deep and meaningful way. And yet, along with those exceptional abilities may come overwhelm, anxiety, underachievement, burnout, or a sense of being misunderstood, even in places meant to help. In my practice, I work with gifted individuals—children, adolescents, and adults—who are navigating life with exceptional potential and equally complex challenges. This is not a side offering or an add-on; it’s at the heart of how I think, how I listen, and how I help. Whether you are a parent searching for answers, an adult seeking affirmation and support, or a clinician looking for a partner in care, you are welcome here.
Explore What Matters to You
Giftedness doesn’t come with a map. Whether you’re here for yourself, your child, or a patient you care about, these topics are here to help you find clarity. Start wherever feels most relevant—click any section to dive deeper.
Could this be me or my child?
Do any of these sound familiar?
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Constantly questioning the rules, the purpose, the meaning of things?
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Noticing what others miss—whether it’s patterns, emotions, or inconsistencies?
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Easily bored but deeply immersed when something clicks?
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Struggling with everyday tasks while thriving in areas others find challenging?
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Holding yourself—or your child—to impossibly high standards?
How This Shows Up in Real Life
In Children:
Perceptive
Frustrated
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School refusal or acting out when learning feels too slow, rigid, or irrelevant
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Difficulty connecting with peers due to different interests or emotional depth
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Meltdowns over “small things” rooted in perfectionism or frustration
In Teens:
Conflicted
Underrecognized
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Underachievement despite obvious potential
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Harsh self-criticism, identity conflict, or emotional withdrawal
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Discomfort with superficial peer interactions or rigid authority
In Adults:
Driven
Disillusioned
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Career dissatisfaction despite success
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Burnout from constantly trying to “do it all” or mask overwhelm
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Relationship challenges tied to feeling misunderstood or "too much"
What Makes It So Hard?
Exploring why giftedness often comes with struggle, confusion, or even misdiagnosis.
Giftedness isn’t always easy to spot—and it’s even harder to support when it shows up in unexpected ways. In mental health care, gifted individuals are often misunderstood because their challenges don’t follow the usual patterns. What looks like anxiety, defiance, inattention, or mood swings may be something else entirely.
Many physicians, educators, and even families have been trained to recognize giftedness only in terms of academic achievement or IQ scores. But high intellectual potential often comes with heightened emotional sensitivity, a strong sense of justice, asynchronous development, and deep existential questioning. These traits, when unsupported, can lead to frustration, misdiagnosis, or even burnout.
There are a few key things that help explain why this population often struggles to get the right kind of support:
What Giftedness Is, What It’s Not, and What It Can Become
Understanding Giftedness in Mental Health Care
Depth
Speed
Intensity
Giftedness is not just about being smart. It’s about how a person experiences the world—often intensely, quickly, and differently. Many gifted individuals process emotions and ideas deeply. They question, analyze, and observe more than their peers. And when their environment doesn’t recognize or support these traits, they may internalize the idea that something is wrong with them.
Common Misconceptions
Assumptions
Lack of Oversight
Misunderstanding
Gifted individuals are often assumed to be doing fine because they’re “high-functioning.” But success in one area—grades, vocabulary, or career performance—can mask serious struggles in another.
Misunderstandings like these delay proper care:
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“They’re too smart to need help.”
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“They just need to try harder.”
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“They’re being difficult on purpose.”
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“They’re doing well in school—how bad can it be?”
These beliefs often keep gifted individuals from getting the nuanced, flexible care they need.
Webb’s Framework:
Idealism
Disillusionment
Hope
Psychologist James T. Webb described a pattern many gifted individuals follow:
They begin with idealism—high hopes, big dreams, and a belief that things can and should be better.
But when the world doesn’t meet those expectations, they often fall into disillusionment—feeling misunderstood, out of place, or like they’ll never belong.
With support, reflection, and connection, many rediscover hope—and begin to see how their unique mind and experiences can make a real difference.
From Misbehavior
to Misunderstood
to Valued Strengths
A chart to help reframe what might be going on beneath the surface.
How I Work Differently
What makes my approach suited to complex, misunderstood, or twice-exceptional individuals.
What You Can Expect:
A Whole-Person, Whole-System Approach
Thoughtful
Integrative, and Developmentally Informed
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I don’t start with a diagnosis. I start with you.
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Whether I’m working with a child, teen, or adult, I’m looking to understand where you’ve been, how you process the world, and what’s standing in your way right now. My training spans child, adolescent, and adult psychiatry, psychotherapy, and integrative medicine, which allows me to take a broader and more flexible view of what’s going on—developmentally, emotionally, and systemically.
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I consider your whole story. How your mind works. How your environment supports—or suppresses—your potential. What tools you’ve already tried. And what else might be possible.
Not Pathologizing:
Looking for Fit, Match, and Unmet Needs
Many of the individuals I work with have been labeled as difficult, oppositional, anxious, depressed, or treatment-resistant. Sometimes the treatment truly hasn’t helped. Sometimes the problem isn’t internal—it's a poor match between the person and their environment, a mismatch of pace, intensity, or expectation.
Instead of asking “What’s wrong with you?” I ask:
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What’s not being understood here?
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What’s not being supported?
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What have you outgrown—or never had access to?
This shift opens space for self-compassion, for insight, and for building forward rather than staying stuck in cycles of misdiagnosis or mismatch.
Collaborative and
Systems-Savvy
I don’t work in isolation. I work with families, schools, therapists, primary care providers—anyone who is part of your (or your child’s) world.
That might mean:
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Helping parents or educators understand how a twice-exceptional child learns best
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Translating psychological testing into everyday language and next steps
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Supporting adults navigating high-demand careers or invisible differences
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Advocating for IEP/504 accommodations or workplace flexibility
My job is to help you make sense of your needs, connect to resources that fit, and move toward change that is not only possible—but sustainable.
Support for Adults, Families, and Providers
Having the right resources can make all the difference—especially when navigating a path that often feels confusing, isolating, or misunderstood. Whether you’re a parent trying to advocate for your child, an adult seeking clarity about lifelong patterns, or a provider supporting a complex patient, these tools are here to offer guidance, connection, and next steps. You don’t have to figure it all out alone.
(COMING SOON)
Priority Blog Topics (COMING SOON) When High Intelligence Is Misunderstood: The Hidden Struggles of Gifted Adults Beyond the Label: Understanding Twice-Exceptionality in Real Life Why Gifted Kids Get Misdiagnosed—and What We Can Do About It What I’ve Learned from Working with Gifted and 2e Patients Perfectionism, Burnout, and Belonging: A Physician’s Story How to Advocate When You or Your Child Doesn’t “Look Struggling” Giftedness Across the Lifespan: From School to Work to Relationships Rethinking Resistance: Why Gifted Patients Sometimes Struggle in Therapy How Schools (and Parents) Can Better Support Twice-Exceptional Students The Power of Fit: Why Environment Matters More Than You Think
What Happens Next?
If you're here, something probably resonated. Maybe you see your child in these descriptions. Maybe you see yourself. Maybe you're a provider looking for the right fit for a patient you care about. This is often the moment where people pause—wondering if it’s worth reaching out, or if they’ll be understood this time.
Here’s what to expect:
🔹 Initial Contact
You can send a message or request a consultation using this contact form or the link below. You don’t need to have everything figured out—that’s what we’ll do together.
If we both feel it’s a good fit, we’ll talk about what working together could look like—whether that means ongoing care, focused consultation, or something in between.
🔹 Consultation or Intake
We’ll build on our initial conversation. I’ll listen, ask questions, and help clarify what’s going on. Together, we’ll decide what kind of support might be most useful.
🔹 Collaboration
Whether through ongoing care, a one-time consultation, or collaboration with another provider, we’ll make a plan that feels useful, respectful, and aligned with your needs.
Let’s Work Together
345 W Washington Ave, Ste 307
Madison, WI 53703
E-Mail: drkathy@centeredpsychiatry.org
Tel: 608-305-4150
Fax: 608-305-8736
(COMING SOON!)