Psychiatry & Psychotherapy Podcast
Join David Puder as he covers different topics on psychiatry and psychotherapy. He draws from the wisdom of his mentors, research, in-session therapy and psychiatry experience, and his own journey through mental health to discuss topics that affect mental health professionals and popsychology enthusiasts alike. Through interviews, he dialogues with medical students, residents, expert psychiatrists and psychotherapists, and people who have been through their own mental health journey. This podcast was created to help others in their journey to becoming wise, empathic, genuine and connected in their personal and professional lives.
Episodes
Postpartum Psychosis: Diagnosis, Treatment, Lithium, and Relapse Prevention with Dr. Veerle Bergink
In this essential episode of the Psychiatry & Psychotherapy Podcast, Dr. David Puder sits down with internationally renowned expert Dr. Veerle Bergink, Director of Mount Sinai's Women's Mental Health Center, for an in-depth discussion of postpartum psychosis. Covering early warning signs and symptoms, differential diagnosis including anti-NMDA receptor encephalitis and thyroid issues, a highly eff
Postpartum Depression and Problem-Focused Psychodynamic Psychotherapy: Understanding the Five Core Conflicts
In this episode, Dr. Puder talks with reproductive psychiatrist and psychoanalyst Dr. Alyson Gorun and Dr. Fredric Busch about postpartum depression and problem-focused psychodynamic psychotherapy. They focus on the five core conflicts (difficulty tolerating anger, idealized expectations of parenthood, struggles with dependence, fear of separation and abandonment, and fear of intrusion) that often
Postpartum OCD vs Postpartum Psychosis: Intrusive Thoughts of Infant Harm, How to Screen, and Lithium Prevention with Dr. Katie Unverferth
In this episode of the Podcast, Dr. David Puder sits down with reproductive psychiatrist Dr. Katie Unverferth, Director of the UCLA Women's Life Center and Medical Director of the UCLA Maternal Mental Health Program, to clarify the critical differences between common postpartum intrusive thoughts of infant harm, postpartum OCD, and true postpartum psychosis. They discuss how nearly all new mothers
East of Eden Reflective Function Collapse: Psychodynamic Therapy, Steinbeck, and How to Heal the Characters
In this episode, Dr. David Puder and his psychodynamic psychotherapy training cohort apply reflective function (RF) and mentalization concepts to John Steinbeck's masterpiece East of Eden. They examine how Reflective Function collapses under shame, rejection, threat, and attachment arousal across key characters. The discussion highlights that true personality health is not the absence of aggressio
Postpartum Psychosis: Symptoms, Warning Signs, Risk Assessment, and Treatment with Dr. Furey and Dr. Puder
In this essential episode, Dr. David Puder sits down with board-certified reproductive psychiatrist Dr. Katrina Furey to unpack postpartum psychosis. They cover its early warning signs, symptoms, diagnostic challenges, risk assessment, and evidence-based treatment. They discuss classic onset within days to weeks after delivery, common delusions centered on the infant, fluctuating mental status, th
Working with Transference: Timing, Technique, and the Here-and-Now with Jonathan Shedler
In this practical Q&A episode with Dr. Jonathan Shedler, the psychodynamic psychotherapy cohort explores working with transference in real time, focusing on timing, technique, and the here-and-now. Shedler addresses how to recognize meaningful transference patterns, decide when an interpretation will open growth versus overwhelm the patient, and adapt the work across levels of personality organiza
Mentalization-Based Therapy (MBT) Explained: Practical Techniques to Improve Clinical Outcomes in Borderline Personality Disorder, OCD & Narcissism
In this episode, Dr. David Puder speaks with Robert Drozek, clinical director of the Mentalization-Based Treatment (MBT) Clinic at McLean Hospital and teaching associate at Harvard Medical School, about practical Mentalization-Based Therapy techniques to improve clinical outcomes in borderline personality disorder (BPD), OCD, and narcissism. Drozek explains the "What, Why, and How" model of mental
Nancy McWilliams on Shame, Transference, Personality Disorders & Becoming a Better Therapist
In this in-depth interview, Dr. David Puder welcomes renowned psychoanalyst and author Dr. Nancy McWilliams to discuss essential clinical topics from her seminal books Psychoanalytic Diagnosis and Psychoanalytic Psychotherapy. Dr. McWilliams shares practical wisdom on working with shame in therapy by emphasizing self-acceptance over mere self-knowledge, along with powerful insights into transferen
Murderbot: Schizoid Personality, Neurodivergence, and the Search for Humanity in AI
Dr. David Puder and Dr. Eric Bender explore the Apple TV+ series Murderbot through a psychiatric lens. Based on Martha Wells' Murderbot Diaries, they analyze the hacked SecUnit's journey as a profound portrait of schizoid personality dynamics, neurodivergence, social anxiety, masking, trauma, and the deep human longing for connection while fearing it. Drawing on Nancy McWilliams' work on schizoid
Side Effect Mastery in Psychopharmacology: Rawlings–Thompson A-F Classification, Low Slow Titration & Real-World Management with Dr. Michael Cummings & Dr. Blaire Heath
Dr. David Puder sits down with psychopharmacology expert Dr. Michael Cummings and Dr. Blaire Heath to discuss Side Effect Mastery in Psychopharmacology. This episode dives deep into the Rawlings–Thompson A-F Classification system for understanding and managing medication side effects, emphasizing low and slow titration strategies to improve tolerability and patient outcomes. They discuss practical
Disengagement Precedes Enactment: Mastering Countertransference with Dr. Karen Maroda
In this episode of the podcast, Dr. David Puder sits down with Dr. Karen Maroda, a renowned psychoanalyst, assistant professor of psychiatry at the Medical College of Wisconsin, and author of influential books including The Power of Countertransference and The Analyst's Vulnerability. Together they explore a powerful clinical insight: disengagement precedes enactment. Learn how therapists' unproce
Male Survivors of Sexual Abuse: Shame, Masculinity, Disclosure & Healing in Therapy with Doriel Jacov
Doriel Jacov joins Dr. Puder to explore the often-overlooked struggles of male survivors of sexual abuse. With one in six males experiencing childhood sexual abuse before age 18, Jacov unpacks the profound impact of shame, masculinity norms, disclosure barriers, and identity fractures that make healing uniquely challenging for men. The conversation covers grooming, power imbalances, coercion, the
Trauma-Specific Reflective Functioning (T-RF): 5 Trauma Mentalization Profiles & Impact on Parenting
In this episode, Dr. David Puder explores Trauma-Specific Reflective Functioning (T-RF) with researchers Dr. Nicholas Berthelot and Dr. Julia Garron-Bissonnette. Discover how childhood trauma affects mentalization and learn about the five distinct trauma mentalization profiles identified in mothers with histories of maltreatment: identification with the perpetrator, functionally grandiose, absorbe
Cohort Group Consultation and Reflective Function: Transforming Countertransference into Clinical Insight
In this episode, Dr. David Puder is joined by cohort leaders Dr. Allie Riege and Dr. Jeremiah Stokes to explore how reflective function transforms countertransference into deep clinical insight. Through their experience leading psychodynamic cohort consultation groups, they discuss the challenges therapists face with vulnerability, disavowed emotions, and the gap between theory and real-world appl
Understanding Mature Defense Mechanisms in Psychotherapy: Nancy McWilliams Framework with Clinical Examples from the Tuesday Cohort
In this episode, Dr. David Puder and the Tuesday 2025–2026 Psychotherapy Cohort explore mature and neurotic defense mechanisms through the lens of Nancy McWilliams' influential framework. Building upon the previous discussion on primitive defenses, they provide an in-depth look at how higher-level defenses such as regression, repression, compartmentalization, isolation of affect, intellectualizati
Primitive Defense Mechanisms Explained: Sexualization, Dissociation, Acting Out, Withdrawal, Denial, Splitting, Omnipotent Control, Projective Identification
In this episode, Dr. David Puder and his talented Cohort deliver a comprehensive exploration of primitive defense mechanisms, which are the earliest, most fundamental ways the mind protects us from overwhelming anxiety, trauma, and threats to the self. Drawing directly from Nancy McWilliams' Psychoanalytic Diagnosis, they break down key primitive defenses. You'll hear clear definitions, develop
Problem-Focused Psychodynamic Psychotherapy: Targeting Symptoms, Relationships, Trauma & Behavioral Change with Dr. Fredric N. Busch
In this episode, Dr. David Puder sits down with Dr. Fredric N. Busch, psychiatrist, psychoanalyst, and clinical professor at Cornell and Columbia, to explore Problem-Focused Psychodynamic Psychotherapy, which is a practical, targeted approach that integrates psychodynamic principles with clear symptom relief, relationship repair, trauma processing, and behavioral change. Dr. Busch explains how to
Psychiatrist Effect in First-Episode Psychosis: HAMLETT Study, Antipsychotic Tapering, Dopamine Supersensitivity & Sex Differences with Franciska de Beer
In this episode, Dr. Puder sits down with Franciska de Beer, MSc, first author of landmark HAMLETT-OPHELIA Consortium papers in JAMA Psychiatry, World Psychiatry, and Psychological Medicine. They dive deep into the psychiatrist effect in first-episode psychosis, revealing that individual psychiatrists explain approximately 10% of variance in positive symptom improvement and daily functioning, even
Dissociative Identity Disorder (DID) Explained: Trauma, Neuroscience, Controversies & Recovery
In this episode of the Psychiatry Podcast, Harvard experts from McLean Hospital: Dr. Melissa Kaufman, Dr. Matthew Robinson, and cognitive neuroscientist Dr. Lauren Lebois. Join Dr. David Puder to deliver the clearest, most evidence-based explanation of Dissociative Identity Disorder (DID) available today. Discover how DID is a developmental post-traumatic adaptation rooted in repeated childhood ma
Understanding Delusions Leading to Violence: Types, Assessment, AI Risks & Treatment in Forensic Psychiatry
In this episode, Dr. David Puder is joined by forensic psychiatrist Dr. Michael Cummings, who has spent his career at the world's largest forensic state hospital, and child psychiatrist Dr. Blaire Heath, to examine how fixed false beliefs, or delusions, can lead to aggression and violence. Each guest brings their expertise to discuss the major delusion types most associated with harm in forensic s
What Is Reflective Functioning? Mentalization, Attachment Theory & RF Scoring with Dr. Miriam Steele
In this episode, Dr. Puder hosts a conversation with Dr. Miriam Steele, a leading expert in reflective functioning (RF), mentalization, and attachment theory. They explore the origins of RF from the pioneering work of Peter Fonagy and John Bowlby in the London Parent-Child Project, its role in predicting secure attachments and sensitive parenting, and distinctions from empathy. Conversation topics
Hard Feelings: Daniel Smith on Embracing Shame, Envy, Annoyance, and the Wisdom in Dark Emotions
In this compelling episode, Dr. David Puder sits down with New York Times bestselling author and psychotherapist Daniel Smith to explore his latest book, Hard Feelings: Finding the Wisdom in Our Darkest Emotions. They dive deep into the often-avoided world of "negative" emotions like shame, envy, and annoyance, revealing how these hard feelings carry profound wisdom rather than being obstacles to
Empathy in Therapy: Mastering Empathic Engagement with Dr. Douglas Flemons
In this episode, Dr. Puder engages in a profound conversation with Dr. Douglas Flemons, a seasoned marriage and family therapist and author of the newly released Empathic Engagement in Clinical Practice. Drawing from over 30 years of supervising family therapists, Dr. Flemons redefines empathy as an active, pursued skill rather than a passive feeling, distinguishing it sharply from sympathy. Explo
How to Overcome Guilt: Break Free from Unreasonable Expectations with Jennifer Reid, MD
In this episode, we welcome psychiatrists Dr. Jennifer Reid (author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations) who explores why guilt feels so overwhelming amid post-COVID pressures, perfectionism, and endless roles. Dr. Reid and Dr. Puder differentiate guilt from shame, highlighting adaptive healthy guilt for repairing relationships versus maladaptive generalized guilt ti
Schizoid Dynamics Explored: Kafka's Writings, Fear of Engulfment, and Clinical Insights for Better Empathy
In this episode, Dr. David Puder hosts a discussion on schizoid personality dynamics through the lens of Franz Kafka's life and writings. Discover why the DSM-5's surface-level criteria for schizoid personality disorder falls short, often missing the intense inner conflict between a profound yearning for connection and a paralyzing fear of engulfment. Drawing on the Psychodynamic Diagnostic Manual
Disavowed Anger and Positive Emotions with Paul Wachtel
In this episode, renowned psychologist Paul Wachtel, PhD, returns to explore disavowed anger and disavowed positive emotions in psychotherapy. Discover how anger differs from simple repression, its roots in childhood and preverbal experiences, its positive functions (like self-protection, boundaries, and drive), and the vicious cycles of over-niceness that can lead to frustration, psychosomatic sy
Countertransference and Transference with Frank Yeomans, MD
Join Dr. David Puder and renowned psychodynamic expert Dr. Frank Yeomans in this Q&A episode on countertransference, transference, and projective identification in psychotherapy. Drawing from object relations theory and Transference-Focused Psychotherapy (TFP), Dr. Yeomans illustrates these concepts with real clinical examples. Explore how therapists can harness countertransference to deepen empat
"AI Psychosis": Emerging Cases of Delusion Amplification Associated with ChatGPT and LLM Chatbot Use
Prolonged conversations with ChatGPT and other LLM chatbots have created rapid developments of severe delusions, paranoia, and even death by suicide in some cases. In this episode, Dr. David Puder sits down with Columbia researchers Dr. Amandeep Jutla and Dr. Ragy Girgis to unpack five shocking real-world cases, explain why large language models are dangerously sycophantic, trained to agree, mirro
Genetic and Environmental Influences of Schizophrenia
In this episode, Dr. Puder is joined by Dr. Liam Browning and Dr. Nicholas Fabiano to explore the complex genetic and environmental factors that contribute to schizophrenia. They unpack how heritability is measured, what twin and genome-wide association studies reveal, and why the "missing heritability" problem matters for our understanding of mental illness. The discussion also covers how prenata
Combatting the Negative Effects of Sleep Deprivation
In this episode, Dr. David Puder and Dr. Brandon Luu explore the science of sleep deprivation. How missing sleep impacts your brain, metabolism, emotions, and long-term health. Discover evidence-based strategies that can help you protect cognitive performance and recover from sleep loss, including exercise, creatine, caffeine, and bright light therapy. We'll discuss studies showing how even short
Devaluation, Transference, Narcissism with Diana Diamond
In this episode, Dr. David Puder is joined by world-renowned psychologist Diana Diamond, PhD to explore devaluation, narcissism, attachment, and transference in psychotherapy. Together they examine why patients with narcissistic personality traits or narcissistic personality disorder (NPD) often devalue their therapists, how dismissing and disorganized attachment styles shape treatment, and why th
Intergenerational Trauma Explained: The Role of Reflective Function and Mentalization in Healing Attachment
In this episode, we explore how intergenerational trauma shapes attachment patterns and how reflective function (RF) and mentalization can help break the cycle. Drawing on research from Fonagy, Slade, and Berthelot, we examine how trauma-specific reflective functioning influences disorganized attachment and how therapies such as Mentalization-Based Therapy (MBT), Transference-Focused Psychotherapy
Understanding Real Event OCD: When the Past Fuels Obsession
In this episode, Dr. David Puder is joined by OCD specialist Kevin Foss to dive deep into Real Event OCD, which is a form of obsessive-compulsive disorder where real past experiences become the focus of endless rumination, guilt, and shame. Together, they unpack the symptoms, real-life examples, and how this subtype differs from PTSD, moral injury, and other forms of OCD. The discussion highlights
Identity Diffusion
In this episode, Dr. David Puder and Mark Ruffalo dive into the history and theory of identity diffusion, from Kernberg's structural model and Gunderson's work on BPD to Akhtar's clinical descriptions. We explore how identity diffusion shows up in patients' lived experiences—feelings of emptiness, fractured self-image, lack of authenticity—and what these struggles mean for psychotherapy. You'll al
Cannabis and Depression, Anxiety, PTSD, Sleep, and Cognitive Function Update and Review
In this episode, we explore the latest 2025 research on cannabis and mental health. Our discussion covers how cannabis use impacts depression, anxiety, PTSD, sleep, cognitive function, and cannabis use disorder (CUD). While many patients report short-term relief from symptoms, studies reveal complex risks, including increased odds of mood disorders, suicidality, impaired cognition, and withdrawal
Regulating Our Emotions as Parents with Alissa Jerud, PhD
Parenting brings love, joy and plenty of emotional challenges. In this episode, clinical psychologist Dr. Alissa Jerud explores how parents can better understand and regulate their emotions instead of getting stuck in cycles of frustration, anxiety, or control. Drawing on exposure therapy, DBT skills, and her Emotion-Savvy Parenting approach, Dr. Jerud introduces practical tools: the ART framework
Psychodynamic Psychopharmacology: Insights from Dr. David Mintz
In this episode, I engage in a shared-interest conversation with Dr. David Mintz, a psychiatrist with over 30 years of experience at the Austen Riggs Center, about his book Psychodynamic Psychopharmacology: Caring for the Treatment-Resistant Patient. Mintz explores the integration of psychodynamic principles into medication prescribing, emphasizing that psychiatric treatments are not purely biomed
Catatonia in Children and Teens
Catatonia in children and teens is underdiagnosed, frequently misunderstood, and potentially fatal if left untreated. In this episode, Dr. David Puder and Dr. Annabel Kuhn interview Dr. Joshua Ryan Smith—child and adolescent psychiatrist and division director at Vanderbilt University—to explore the essential clinical skills and medical knowledge needed to identify and treat pediatric catatonia. Yo
The Bear: Trauma, Personality, and Attachment with Dr. Eric Bender and Dr. David Puder
In this episode, Dr. David Puder is joined by psychiatrist Dr. Eric Bender to explore the psychological depth of the Emmy Award-winning show, The Bear (FX). Through a psychodynamic lens, they examine Carmy's character—his trauma, complex PTSD, obsessive-compulsive personality traits, and avoidant attachment style. They also break down the borderline dynamics in his family, especially his mother'
Depressive Personality Style with Jonathan Shedler
Dr. David Puder and psychologist Dr. Jonathan Shedler explore depressive personality style—how it differs from clinical depression and why it often goes unrecognized. Through a detailed role play, they demonstrate how self-criticism, unconscious guilt, emotional deprivation, and suppressed anger emerge in therapy. They discuss: How depressive personalities form in childhood The role of introje
Cannabis and Psychosis: The Link Between THC Use and Mental Health Risks
Dive deep into the connection between cannabis (THC) and psychosis in this enlightening episode with Dr. David Puder. Explore cutting-edge research on how cannabis impacts neurodevelopment, particularly during adolescence, and discover genetic and environmental factors that can amplify psychosis risk. This episode provides valuable insights into recognizing cannabis-induced psychotic symptoms, und
Transference Focused Psychotherapy & Personality Disorders with Dr. Otto Kernberg
In this episode, Dr. Otto Kernberg, a pioneer of Transference-Focused Psychotherapy (TFP), discusses personality disorders through a psychoanalytic lens. Explore key insights into Borderline Personality Disorder (BPD), identity diffusion, primitive defense mechanisms such as splitting and projective identification, and the complexities of narcissistic, paranoid, schizoid, and histrionic personalit
Creatine and Mental Health
In this episode of Psychiatry & Psychotherapy, Dr. David Puder hosts a deep dive with experts Nicholas Fabiano, MD, Brandon Luu, MD, Joshua Mangunsong, MS3, and Liam Browning, MS4 into the exciting potential of creatine supplementation for mental health and cognitive enhancement. They explore cutting-edge research on how creatine can improve mood disorders, including depression and anxiety, enhanc
Ketogenic Diet Review and Update with Dr. Matt Bernstein
Explore the transformative potential of the ketogenic diet for mental health with expert Dr. Matt Bernstein, a pioneer in metabolic psychiatry. Learn how targeting metabolic dysfunction can profoundly improve psychiatric outcomes in bipolar disorder, schizophrenia, depression, and epilepsy, with fewer side effects than traditional treatments. Discover actionable insights on diet, metabolism, and b
Clozapine & Schizophrenia with Michael Cummings, MD
Join Dr. David Puder and expert psychopharmacologist Dr. Michael Cummings in a detailed discussion on Clozapine, the gold standard medication for treatment-resistant schizophrenia. They explore recent significant updates, including the removal of the Clozapine REMS program, which simplifies patient care and medication management. This episode covers optimal dosing practices, managing side effects,
The Serotonin Hypothesis: Controversies and Nuance with Awais Aftab, MD
Is depression really caused by low serotonin? Dr. Awais Aftab joins Dr. David Puder to explore the serotonin hypothesis, antidepressant efficacy, and the controversies surrounding SSRIs. They dive into the history of the serotonin deficiency theory, key research on antidepressants vs. placebo, and how neuroplasticity, psychotherapy, and lifestyle changes factor into depression treatment. The episo
Transference Focused Psychotherapy, Borderline Personality Disorder, Narcissism, with Frank Yeomans, MD
In this episode, Dr. David Puder interviews Dr. Frank Yeomans, a leading expert in Transference-Focused Psychotherapy (TFP) and personality disorders, to explore the treatment of Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD). They discuss object relations theory, identity diffusion, splitting, and the therapeutic relationship in TFP. Dr. Yeomans shares clinical
Reframing "Goodbye" as a Transition: Guidance from Dr. Tarr
How do we navigate therapy termination as a transition rather than a loss? In this episode, Dr. John Tarr explores the emotions, challenges, and growth opportunities that come with ending therapy. We discuss how termination triggers past attachment wounds, the psychological impact of separation, and how therapists can guide patients through this process. Learn how reframing 'goodbye' can lead to l
Cold Exposure for Mental Health
Can cold exposure improve your mental health? In this episode, we explore the science behind cold therapy methods like ice baths, cryotherapy, cold-water swimming, and cold showers. Backed by research, we dive into the physiological and psychological effects of cold exposure, including its impact on mood, anxiety, dopamine, norepinephrine, and stress resilience. We discuss historical practices, be
Borderline Personality Disorder: Splitting & Identity Diffusion with Mark Ruffalo
In this episode of the Psychiatry & Psychotherapy Podcast, Dr. David Puder is joined by Mark Ruffalo to dive deep into the complexities of borderline personality disorder (BPD). Together, they unpack Donald Burnham's influential 1966 paper on splitting and identity diffusion, exploring themes of self-concept, relational dynamics, and the therapeutic challenges posed by BPD patients. Learn how spli
Exercise Compared to Medications or Therapy for Depression
Can exercise truly rival medications and therapy for treating depression? In this episode, Dr. David Puder, Dr. Nicholas Fabiano, and Dr. Brendon Stubbs dive deep into the science of physical activity as a treatment for mental health. Discover the unique antidepressant mechanisms of exercise, how it compares to traditional treatments, and practical tips for prescribing it to patients. Learn about
Beyond the Myths of Psychosis: Understanding, Acceptance, and Paths Forward
In this episode, Dr. David Puder sits down with Dr. Stijn Vanheule, professor of clinical psychology and psychoanalysis, to challenge misconceptions about psychosis and explore paths to understanding and recovery. They discuss psychosis as more than a clinical label, delving into its connection to existential struggles and creative expression. Dr. Vanheule explains primary-process thinking, how tr
Comprehensive Obsessive-Compulsive Disorder (OCD) Treatment Guide: Evidence-Based ERP Approaches and Best Practices for Clinicians
In this episode, Dr. David Puder dives deep into the world of Obsessive-Compulsive Disorder (OCD) with renowned expert Dr. Fred Penzel, who brings over 43 years of experience to the table. Together, they explore groundbreaking approaches to treating OCD, including Exposure and Response Prevention (ERP), cognitive restructuring, and embracing uncertainty. Dr. Penzel shares fascinating insights into
Pathological Narcissism: Effective Treatment with Mentalization-Based Therapy (MBT)
In this episode, Dr. David Puder, alongside experts Anthony Bateman, Dr. Brandon Unruh, and Robert Drozek, delves into the complexities of treating pathological narcissism with Mentalization-Based Therapy (MBT). They explore practical strategies to help individuals with Narcissistic Personality Disorder develop self-awareness, emotional regulation, and healthier relationships. Learn how MBT can tr
Burnout in Healthcare: How Depersonalization and Dissociation Manifest, and How to Overcome Them
In this episode, we explore the emotional toll of burnout on healthcare professionals with Dr. Jessi Gold, a psychiatrist and Chief Wellness Officer at the University of Tennessee System. Burnout often manifests as depersonalization—a form of emotional detachment that shields clinicians from the relentless trauma they witness. Dr. Gold delves into how this protective mechanism can lead to emotiona
Psychology and Inside Out 2: A Breakdown of Adolescent Emotional Lives
In this episode, Dr. David Puder, alongside guests Rachel Blackston and Dr. Eric Bender, dives into the psychological insights presented in Pixar's Inside Out 2. Together, they explore the complex emotional world of adolescence, focusing on the challenges Riley faces as she navigates new emotions—like Anxiety, Envy, and Embarrassment—that reflect common experiences during teenage years. Through ex
Understanding Borderline Personality Disorder (BPD) Medications & Treatment
Borderline Personality Disorder (BPD) is known for its complexity, but how should clinicians approach treatment? In this episode, Dr. Michael Cummings joins us to explore the role of medications in managing BPD, when to use them, and why psychotherapy remains the cornerstone of treatment. From pharmacotherapy to alternative approaches like exercise and omega-3s, we break down the latest evidence a
Managing Weight Gain from Psychiatric Medications with Dr. Michael Cummings
Join Dr. David Puder and renowned psychopharmacologist Dr. Michael Cummings as they dive deep into the complex relationship between psychiatric medications and weight gain. In this episode, they explore the metabolic challenges posed by antipsychotic medications, focusing on cutting-edge solutions like GLP-1 agonists. Whether you're a mental health professional or someone impacted by these medicat
Paul Wachtel's Approach to Integrative Psychotherapy: Exploring Attachment, Anxiety, and the Disavowed Self
In this episode, we explore the innovative work of Dr. Paul L. Wachtel, a leading psychologist known for his integrative approach to psychotherapy. Dr. Wachtel challenges single-framework therapy models, advocating for a flexible approach that draws from cognitive-behavioral, psychodynamic, humanistic, and other modalities. We discuss his concept of the "disavowed self"—the parts of oneself that a
Sauna & Heat Exposure's Impact on Mental & Physical Health
In this episode, Dr. David Puder and Liam Browning delve into the ancient practice of sauna and modern heat exposure therapies, exploring how they influence both physical and mental health. From boosting cardiovascular and cognitive health to potentially alleviating symptoms of depression and chronic diseases, this discussion reveals the science behind heat therapy's therapeutic effects. Discover
Writing to Overcome Trauma and Improve Your Mental and Physical Health
In this episode, we dive into the fascinating world of expressive writing and explore how turning your trauma into a narrative can lead to real mental and physical benefits. Join us as we break down the science behind the Expressive Writing Paradigm and share groundbreaking research by Dr. James Pennebaker and others. From reducing PTSD symptoms to improving mood and stress levels, discover how th
Eating Disorders: Empathy, Alexithymia, Reflective Function
Eating disorders are often understood through a medical or behavioral lens, focusing on symptom reduction. But what if we've overlooked something deeper—something rooted in the complex emotional lives of our patients? In this episode, Dr. Tom Wooldridge, a psychoanalyst and expert in eating disorders, joins Dr. David Puder to explore the psychoanalytic perspective on treating these conditions. By
Where Psychiatry Meets Politics: The Goldwater Rule
There is an extensive history of psychiatry and politics intersecting. Perhaps the most visible flashpoint occurred during the 1964 presidential campaign and gave rise to a movement in organized psychiatry that has resulted in issuance of formal ethical guidance (the "Goldwater Rule"). In this episode, Dr. David Puder and Dr. Mark Mullen discuss the pros and pitfalls of the Goldwater Rule and psyc
Adverse Childhood Experiences - HPA axis & Brain changes: cortisol, amygdala, hippocampus, cytokines, & epigenetics (Part 3 of ACE series)
In this week's episode, we continue our series on Adverse Childhood Experiences by delving deeper into the lasting effect of ACEs on the brain and body. We explore the intricate impact of ACEs on the HPA axis, inflammation, and neurobiology, shedding light on their role in various psychiatric disorders. We highlight how these changes may indicate a shared phenotype resulting from early adversity b
Shrink Next Door: A Psychiatrist's Analysis
Listening to The Shrink Next Door elicited a range of emotions in me, including angst, sadness, intrigue, and heartache. For those unfamiliar with the story, it revolves around a psychiatrist named Ike who isolates his patient, Marty, from his family, takes over his business, lives in his house, charges him over a million dollars, and makes him undertake various projects for him. We will discuss t
Understanding Complex PTSD and Borderline Personality Disorder
The purpose of this episode is to provide a clear and simple guide for clinicians on the diagnosis of complex PTSD (C-PTSD) and how it differs from post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD). It is intended to complement and add to recent episodes on attachment and trauma: 213: Reflective Functioning, 203 and 204 on adverse childhood experiences. In today's
Q&A with Dr. Cummings Part 2
In this episode, we welcome back Dr. Michael Cummings to answer questions sent in by podcast listeners. Topics include Valproic Acid, Lithium, Treating Veterans, Restless Leg Syndrome, and much more. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video.
Reflective Functioning: The Key to Attachment with Dr. Howard Steele
In this episode, we discuss "reflective function," which is a precursor to the concept of mentalization. Reflective function is best understood not as synonymous with mentalization, but as a scale from -1 to 9, based off certain adult attachment interview questions that measure the person's ability to describe their own and others' internal states, motivations, and articulate a nuanced and unique
Bruce Perry on the Healing Power of Human Connection and Resilience in Trauma
In today's episode, we talk with Dr. Bruce Perry who co-authored, The Boy Who Was Raised As A Dog, Born For Love: Why Empathy is Essential and Endangered, and What Happened to You? Conversations on Trauma, Resilience, and Healing (2021). We are also joined by Megan White Zappitelli, M.D., a child and adolescent psychiatrist, and Maddison Hussey, M.D., a child and adolescent fellow. By listening t
Early Psychosis: Detection and Treatment
In this episode, we are joined by a panel of experts to discuss treatment of psychosis. Experiences of psychosis are common. When these experiences lead to interference in achieving life goals and/or distress, individuals can benefit from seeking evidenced-based care. The earlier individuals experiencing psychosis come to treatment, the better the outcomes. We are all allies in connecting these yo
Q&A with Dr. Michael Cummings
In this episode, we welcome back fan favorite Dr. Michael Cummings and ask questions sent in by listeners. Topics include Schizophrenia, Social Media Trends, and the SSRI controversy. We are thrilled to dedicate an episode that allows individuals to ask pointed questions and glean from Dr. Cummings' expertise. By listening to this episode, you can earn 1 Psychiatry CME Credits. Link to blog. Lin
PTSD and Cognitive Processing Therapy with Patricia Resick
Learning how to approach patients with PTSD and severe trauma is necessary to help long term. Dr. Patricia Resick has plenty of experience in dealing with PTSD and is on the podcast today, sharing her wisdom so that we may better serve patients suffering from trauma. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video.
What People Want From Therapy with Linda Michaels
Therapies of depth, insight, and relationship have been missing from, if not pushed out of, the public conversation on mental health treatment. After decades of attack from multiple fronts, these therapies are misunderstood, undervalued, and overlooked by the general public. In order to address this challenge and change this trajectory, we must start by listening to the public and understand their
5 Factors and Domains of Psychiatric Care
In this Episode, Dr. David Puder, Dr. Adam Borecky, and Joanie Burns discuss the 5-factor approach to holistic, patient-centered psychiatric care. This approach takes into account that each individual who seeks care is unique in their physiological and psychological make-up and that multiple factors influence both physical and mental health (for better or worse). The 5-factor approach to treatmen
Mentalization Based Therapy (MBT), with Dr. Anthony W. Bateman, MA, FRCPSYCH and Dr. Peter Fonagy, Ph.D., FBA
In this episode, we are joined by Dr. Anthony W. Bateman and Dr. Peter Fonagy to discuss their expertise on Mentalization. Mentalization refers to the capacity to reflect upon and understand one's own state of mind and the states of mind of others. This involves recognizing and making sense of one's own and others' emotions, beliefs, needs and desires. People use this tool consciously and uncon
Beginning the Treatment with Jonathan Shedler, PhD
Dr. Jonathan Shedler is well known for his work on the efficacy of psychodynamic therapy. He has highlighted the importance of the initial phase of therapy in establishing a foundation for successful treatment. Dr. Shedler strongly believes the consultation phase is crucial to developing a working alliance between client and therapist and building a treatment frame and structure. Without this foun
Adverse Childhood Experiences Part 2: Measurement, Impact on Future Mental Health, Dissociation, and Timing of Trauma
In this week's episode of the podcast, Dr. Kuhn, Liam Browning, and Dr. Puder will continue their discussion regarding adverse childhood experiences (ACEs) and their influence on the development of future mental health disorders. The greatest predictive factor of the relationship between ACEs and future mental health disorders has to do with the severity, duration, and number of traumatic events.
Adverse Childhood Experiences and Their Lasting Impact on Health: A Comprehensive Guide
In today's episode, Dr. Annabel Kuhn, Liam Browning, and Dr. David Puder, embark on an in-depth exploration of adverse childhood experiences (ACEs) and their profound impact on adult mental and physical health. The CDC defines ACEs as, "potentially traumatic events that occur in childhood." ACEs include (but are not limited to) physical, emotional, sexual abuse, neglect, household dysfunction, s
Cognitive Behavior Therapy (CBT) with Dr. Judith Beck
In today's episode of the podcast, we interview Dr. Judith Beck, a prominent figure in the field of psychology and author of the highly regarded textbook, Cognitive Behavior Therapy: Basics and Beyond, which is a staple in the academic journey of many students in psychiatry, psychology, counseling, social work, and psychiatric nursing. This book, translated into 20 languages, is a key resource in
Psychotic Depression with Dr. Cummings
The underreporting of psychotic symptoms by patients in depression is a significant concern, frequently driven by the fear of consequences like hospitalization or the stigma of embarrassment. We'll discuss the history, the differential to consider when thinking of psychotic depression, mechanisms, and treatment. Notably, individuals with psychotic depression face a suicide rate double that of the
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