Psychiatry & Psychotherapy Podcast

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 transform the therapeutic journey for those who often feel misunderstood or resistant to change.

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 emotional numbness, distancing healthcare workers from their patients and even themselves. We discuss the concept of alexithymia, where prolonged detachment causes clinicians to lose touch with their own emotions, making it challenging to process trauma or empathize with patients. Dr. Gold offers practical strategies for overcoming burnout, such as early intervention, therapy, setting emotional boundaries, and advocating for systemic change within healthcare institutions. Tune in to learn how reconnecting with the meaning behind their work can help clinicians rediscover a sense of purpose and resilience in their careers.

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 expert analysis, the conversation unpacks how these emotions influence identity formation, self-doubt, and social dynamics. The discussion also addresses the impact of childhood experiences, how adolescents process peer pressures, and the role of parental responses in supporting emotional growth. Join us as we delve into the film’s depiction of teenage mental health and its psychological accuracy, providing parents, therapists, and teens themselves with valuable takeaways on emotional resilience and self-discovery.

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 and offer practical insights for clinicians. Don’t miss this deep dive into managing one of psychiatry’s most challenging disorders.

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 medications, this conversation offers practical insights on how to manage medication-induced weight gain through diet, exercise, and pharmacological interventions. Learn how to tackle this growing issue in mental health care with a thoughtful, science-backed approach.

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 are unconsciously denied—and how therapists can help clients reclaim these aspects to foster growth. We also dive into how attachment theory and integrative methods can be used to treat anxiety, phobias, and interpersonal issues, providing practical insights for both therapists and those interested in understanding human behavior more deeply. Join us for an engaging conversation on advancing therapeutic practices.

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 how cultures worldwide have utilized heat for healing, the physiological benefits it offers, and practical insights into incorporating these practices into daily life. Join us as we uncover the evidence-based benefits and limitations of sauna use, exercise, and other heat therapies.

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 this simple yet powerful technique can help you process emotions, gain new insights, and ultimately promote long-term healing.

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.

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 psychiatry's role in politics.

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 but that they likely do not explain the entire effect ACEs have on an individual.

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 the podcast's characters as if they are fictional. The podcast, akin to House of Cards for the psychotherapy world, reveals the manipulation and betrayal that can occur behind the scenes. Just as House of Cards exposed viewers to the Machiavellian tactics in politics, The Shrink Next Door disrupts the sacred space of the therapy office. This week, I am joined by Dr. Eric Bender, a psychiatrist and psychotherapist, to discuss, The Shrink Next Door. Dr. Bender practices in San Francisco, has been featured multiple times on GQ’s online show The Breakdown, Wired magazine’s Tech Help, and on YouTube.

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 episode of the podcast, we are joined by Dr. Adam Borecky. Dr. Borecky is a psychiatrist and therapist who helped author the Connection Index and is part of Dr. Puder’s core team. His practice utilizes a holistic approach towards therapy and medication management.

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.

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 understanding of life from 0 to 12 years old. This scale was developed by attachment researchers at the University of London, including Dr. Howard Steele and Dr. Peter Fonagy.

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.

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 young people to care and services. Recovery is possible—people living with psychosis experiences can lead full, meaningful, and fulfilling lives.

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.

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.

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 needs, values, and preferences about therapy. Dr. Linda Michaels and colleagues conducted an extensive research project, leveraging qualitative and quantitative tools and techniques widely used in the corporate world, focused on “listening” to the public and understanding what people want and need from therapy.  Linda Michaels, PsyD, MBA, is a clinical psychologist in private practice in Chicago. She is also chair and co-founder of the Psychotherapy Action Network (PsiAN), a non-profit that advocates for quality therapy.  Link to blog here.