Psychiatry & Psychotherapy Podcast

Dr. Bergink, a leading expert in women's mental health, joins the podcast to unpack the complex links between perimenopause and mental health, including new-onset or worsening depression, anxiety, panic attacks, brain fog, sleep disruption, and irritability driven by hormone fluctuations rather than simply low estrogen. Discussion surrounds evidence-based insights on distinguishing hot flashes from panic, the real benefits and limits of hormone therapy (HRT) versus SSRIs or CBT-I, myths about testosterone and surgical menopause, elevated risks in bipolar disorder, and why cognitive changes are usually temporary. By listening to this episode, you can earn 1.0 Psychiatry CME Credits. Link to blog Link to YouTube

In this episode of the Podcast, Dr. David Puder is joined by psychiatric geneticist Dr. Consuelo Walss-Bass and Dr. Julio Licinio for a powerful conversation on the early signs, genetics, and treatment of schizophrenia. Drawing from her lived experience growing up with a mother and sister who both have schizophrenia, Dr. Walss-Bass discusses prodromal symptoms, the 287 risk genes identified by the Psychiatric Genomics Consortium, gene-environment interactions, challenges of early intervention, and why clozapine remains the gold standard for treatment-resistant schizophrenia. Link to blog Link to YouTube video

In this essential episode of the podcast, Dr. David Puder and reproductive psychiatrist Dr. Katrina Furey interview pioneering expert Dr. Margaret Spinelli on postpartum psychosis, covering its symptoms, diagnosis, treatment, and prevention. They explore the history of perinatal psychiatry, neonaticide and dissociation, the critical need for mother-baby units, rapid symptom progression, why timely hospitalization and treatment lead to full recovery for most women and much more. Link to blog Link to YouTube video By listening to this episode, you can earn 1.25 Psychiatry CME Credits.

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 effective acute treatment algorithm using benzodiazepines, antipsychotics, and lithium, the remarkable 98% remission rates with proper care, lithium's superior role in preventing relapse during the first postpartum year, the simple but powerful prophylaxis strategy of "baby out, lithium in" for high-risk women with bipolar disorder or prior episodes, the urgent need for mother-baby psychiatric units in the U.S., and the ongoing push to formally classify postpartum psychosis in the DSM. Link to blog Link to YouTube video By listening to this episode, you can earn 0.75 Psychiatry CME Credits.

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 underlie symptoms, shame, attachment reactivation, and stuck behaviors in the perinatal period. This episode explores: -How these dynamics emerge even when parents know what they "should" do -How to integrate psychodynamic insight with medication, sleep, social support, and evidence-based care -Practical ways clinicians can help mothers and fathers mentalize their experiences, reduce guilt, and improve bonding. Link to blog Link to YouTube video By listening to this episode, you can earn 1.25 Psychiatry CME Credits.

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 experience ego-dystonic thoughts of accidental or intentional harm, how to screen without triggering concealment, when severity and compulsions cross into OCD, the role of high-dose SSRIs plus exposure and response prevention (ERP), red-flag signs of ego-syntonic content, agitation, insomnia, and delirium-like states that signal psychosis, and the strong evidence for lithium prophylaxis and acute treatment in high-risk patients. Link to blog Link to YouTube video

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 aggression, dependency, or guilt but the growing capacity to recognize conflicting self-parts, stay in contact with reality, and remain related to imperfect people. Link to blog Link to YouTube video By listening to this episode, you can earn 1.5 Psychiatry CME Credits.

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, the critical distinction from postpartum OCD, elevated risks of filicide and suicide, strong links to bipolar spectrum disorders, and the vital roles of lithium, antipsychotics, sleep protection, ECT, medical workup, and family support. Learn why this psychiatric emergency demands rapid intervention, how most women fully recover, and practical guidance for clinicians and families navigating this rare but treatable condition. Link to blog Link to YouTube video By listening to this episode, you can earn 0.5 Psychiatry CME Credits.

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 organization (neurotic versus borderline). The discussion covers handling negative and erotic transference, protecting the therapeutic frame, triangulation, idealization and splitting, devaluation, projection, and projective identification. Clinicians will also learn to use their own countertransference as essential clinical data, the ongoing value of consultation and supervision, and how to respond to chronic reassurance-seeking without colluding. Link to blog Link to YouTube video

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 mentalizing, how to address psychic equivalence (rigid certainty), pretend mode, and teleological thinking, and offers concrete strategies clinicians can use in session and assign as between-session work to help patients reconnect with difficult emotions, reduce intellectualization, and develop more flexible, reflective ways of understanding themselves and others. Link to blog Link to YouTube video

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 transference, countertransference, and projective identification. The conversation explores how different therapist personality styles influence clinical work, strengths, and vulnerabilities. Additional highlights include building love and trust in the therapeutic relationship, protecting the therapeutic frame, setting early boundaries, and real-world guidance on handling stalking and boundary violations. By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog Link to YouTube video

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 dynamics and D.W. Winnicott, the discussion examines AI identity, reflective functioning, PTSD, and what Murderbot reveals about humanity in the age of artificial intelligence. By listening to this episode, you can earn 1.0 Psychiatry CME Credits. Link to blog Link to YouTube video

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, real-world approaches to common challenges, including orthostatic hypotension, excessive sweating (hyperhidrosis from SSRIs/SNRIs), tremor management, alopecia from valproic acid and lithium, anticholinergic burden, and much more. Dr. Cummings shares his insights on receptor dynamics, metabolizer status, bedtime dosing, and when to reconsider diagnosis after treatment failures. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog Link to YouTube video

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' unprocessed countertransference (irritation, boredom, guilt, anger, or helplessness) often leads to emotional withdrawal before erupting into destructive enactments that can rupture the therapeutic relationship. Dr. Maroda shares candid examples from her own practice, including a personal enactment she later processed with her patient, and demonstrates practical strategies for catching disengagement early, using constructive self-disclosure, and maintaining emotional presence. The conversation features a live role-play, deep discussion of parentification in therapists' histories, setting healthy boundaries, managing guilt and shame, and turning potential pitfalls into opportunities for deeper connection. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog Link to YouTube video

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 myth that survivors become abusers, arousal and body betrayal, sexual identity confusion, trauma reenactment, and the complex transference dynamics that arise in therapy, including erotic transference and projective identification. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog Link to YouTube video

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, absorbed in trauma, global failures in mentalization, and those with no major failures who show remarkable resilience. The conversation examines how these different ways of processing trauma significantly impact parenting, attachment security, and the intergenerational transmission of trauma. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog Link to YouTube video

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 application. The conversation dives into common therapist personality dynamics, enactments, boredom and irritability as valuable clinical data, and how group consultation helps clinicians develop greater self-awareness and empathy in their work. Drawing from Nancy McWilliams' Psychoanalytic Diagnosis and key concepts like concordant and complementary countertransference, this episode offers practical wisdom for mental health professionals seeking to improve their reflective functioning and psychodynamic case conceptualization. Link to blog Link to YouTube video

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, intellectualization, rationalization, moralization, undoing, displacement, reaction formation, and sublimation operate in both everyday life and clinical practice. Filled with rich clinical examples drawn from outpatient psychiatry, emergency settings, trauma work, grief, OCD, and private practice, the cohort discusses the adaptive value as well as the potential costs of these defenses, offering practical insights for recognizing and working with them effectively in psychotherapy. By listening to this episode, you can earn 2.0 Psychiatry CME Credits. Link to blog Link to YouTube video

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, developmental origins, clinical presentations, countertransference implications, literary examples, and real-world clinical vignettes, plus a rich group discussion on when these defenses are adaptive versus maladaptive. By listening to this episode, you can earn 2.5 Psychiatry CME Credits. Link to blog Link to YouTube video

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 identify core problems in the very first session, build a focused psychodynamic formulation, and track progress on symptoms like anxiety, depression, panic disorder, disavowed anger, and over-responsibility rooted in trauma. By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog Link to YouTube video