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Psychiatry & Psychotherapy Podcast
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Psychiatry & Psychotherapy Podcast

Author: David Puder, M.D.

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Join David Puder as he covers different topics on psychiatry and psychotherapy. He will draw 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 will dialogue with both medical students, residents and expert psychiatrists and psychotherapists, and even with 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.
254 Episodes
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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 prenatal factors, childhood trauma, cannabis use, and social adversity increase risk and how modern neuroscience reframes schizophrenia as a disorder of brain connectivity rather than a single genetic disease.
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 bouts of high-intensity interval training (HIIT), proper creatine dosing, and morning light exposure can reverse many of the damaging effects of sleep restriction. 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 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 these cycles can be so painful for clinicians. Dr. Diamond shares clinical insights from Transference-Focused Psychotherapy (TFP), including how to recognize subtle and overt devaluation, how to hold boundaries, how to think psychodynamically about these behaviors, and how to respond without reenacting the patient's internal object relations. The discussion also highlights the role of trauma, reflective functioning, countertransference, and the deeper tragedy of pathological narcissism. By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video
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 (TFP), and Minding the Baby (MTB) strengthen reflective capacity and promote secure attachment. Join Dr. David Puder and colleagues as they discuss the science of mentalization, attachment repair, and trauma healing, bringing together psychoanalytic, developmental, and biological perspectives to offer hope and clinical insight for patients, parents, and therapists alike. 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 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 evidence-based treatments like Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), and medication options, while also offering guidance for loved ones supporting someone with OCD.
Identity Diffusion

Identity Diffusion

2025-09-1601:37:52

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 also hear practical insights into treatment, including empathetic confrontation, fostering continuity of self, and amplifying moments of authenticity. Whether you're a clinician, student, or simply curious about the complexities of identity, this conversation sheds light on one of the most important yet misunderstood dimensions of mental health.   By listening to this episode, you can earn 1.75 Psychiatry CME Credits. Link to blog.
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 challenges. We also examine the evidence behind medical marijuana for PTSD and anxiety, the role of CBD and terpenes, and the long-term effects of cannabis on brain development, academic performance, and overall health. Whether you are a clinician, researcher, or someone curious about cannabis and psychiatry, this update will help you better understand the science, myths, and clinical realities of cannabis use. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video.
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 (Accept, Regulate, Tolerate) to help parents stay grounded during emotional storms. Whether it's managing anxiety, tolerating distress, or responding more calmly to your kids, this conversation is full of evidence-based strategies for building resilience, deepening connection, and showing up as the parent you want to be. Connect with Alissa Jerud on her Instagram or LinkedIn Check out her new book Emotion-Savvy Parenting.  Announcement: for interest in psychotherapy cohort, go to www.psychiatrypodcast.com/cohort By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube   
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 biomedical but profoundly shaped by meaning, symbolism, attachment and interpersonal dynamics. Drawing from his work with treatment-resistant patients, often those with histories of early adversity, the discussion distills how psychodynamics influence medication efficacy, adherence, and overall recovery. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video.
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. You'll learn how to differentiate catatonia from other neuropsychiatric conditions in both neurodivergent and neurotypical children, how to apply tools like the Bush-Francis and Pediatric Catatonia Rating Scales. This episode also unpacks common misdiagnoses in cases involving autism spectrum disorder, schizophrenia, and autoimmune or metabolic conditions. Finally, it offers practical, evidence-based guidance for both inpatient stabilization and outpatient follow-up care. Whether you're a psychiatrist, pediatrician, therapist, or student, this episode offers life-saving insights into one of the most overlooked syndromes in child psychiatry. By listening to this episode, you can earn 1.0 Psychiatry CME Credits. Link to blog. Link to YouTube video.
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's primitive defenses, identity diffusion, and projective identification. The discussion covers dissociation, personality styles, sibling roles, and emotional neglect, drawing connections to clinical work and real-life therapy. This episode gives both clinicians and fans of the show a nuanced understanding of how early attachment, trauma, and family dynamics shape adult behavior. Whether you're a therapist, student, or simply a fan of the show, you'll gain insight into how The Bear reflects complex inner worlds. Link to blog. Link to YouTube video.
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 introjection, self-blame, and gentle idealization Why therapists may miss key dynamics if therapy feels "too good" How to help patients access their real needs and frustrations This episode is ideal for clinicians and anyone interested in deep psychodynamic work. Shedler draws from the work of Nancy McWilliams and Otto Kernberg while offering his own insights on personality, countertransference, and therapeutic technique.   Link to blog. Link to YouTube video. By listening to this episode, you can earn 2 Psychiatry CME Credits.
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, understanding the importance of early intervention, and implementing effective strategies for treatment and prevention. Essential listening for mental health professionals, educators, parents, and anyone interested in the nuanced relationship between cannabis use and mental health.   By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video.
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 personalities. Dr. Kernberg also shares reflections on sexuality, aggression, reflective functioning, and why therapists choose to help others. By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog. Link to YouTube video.
Creatine and Mental Health

Creatine and Mental Health

2025-04-1801:26:53

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, enhance cognitive functions such as memory, attention, and reasoning, and support brain metabolism through its role in ATP regeneration. The episode also reviews clinical trials demonstrating creatine's effectiveness in psychiatric disorders, optimal dosing strategies, and its safety profile. Listen to learn how creatine may revolutionize treatment options in psychiatry. By listening to this episode, you can earn 1.5 Psychiatry CME Credits. Link to blog. Link to YouTube video.
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 brain health backed by the latest scientific research. Tune in to revolutionize your understanding of nutrition's role in mental wellness! By listening to this episode, you can earn 1.75 Psychiatry CME Credits. Link to blog. Link to YouTube video.
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, crucial drug interactions, and approaches to related conditions such as catatonia. An essential resource for psychiatrists and mental health professionals seeking updated clinical insights. By listening to this episode, you can earn 1.75 Psychiatry CME Credits. Link to blog. Link to YouTube video.
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 episode also examines differences between major treatment guidelines, including RANZCP and NICE, and what the latest evidence suggests about the future of mental health care. By listening to this episode, you can earn 1.25 Psychiatry CME Credits. Link to blog. Link to YouTube video. Links for Dr. Awais Aftab: Substack World Psychiatry Conversations in Critical Psychiatry
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 insights on working with paranoid, devaluing, and omnipotent transferences, highlighting how therapists can navigate idealization, devaluation, and therapeutic neutrality. They also compare TFP with other psychodynamic approaches and discuss the role of aggression in mentalization and personality integration. Learn how TFP helps patients develop a stable identity Understand the differences between BPD and NPD treatment Explore the role of transference in psychotherapy Tune in for a deep dive into psychodynamic therapy with one of the field's top experts! By listening to this episode, you can earn 2.0 Psychiatry CME Credits. Link to blog Link to YouTube video
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 lasting transformation, self-reflection, and autonomy. Whether you're a therapist or someone in therapy, this episode provides deep insights into the complexities of closure, loss, and resilience in psychotherapy. Link to blog. Link to YouTube video.    
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Comments (32)

Muntaha

Mental health is one of the most vital aspects of our overall well-being, yet it’s often overlooked. The fast-paced pressures of daily life, unresolved trauma, and emotional challenges can take a toll, leading to anxiety, depression, and other mental health concerns. For many, the first step toward healing is often the hardest — but it’s also the most important one. https://clvpsych.com/

Nov 1st
Reply

Pilgrim's Promise

Need a spit cover on the mic. Lots of mouth noise

Sep 26th
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Az Jay

Thank you for all these wonderful insights covering such amazing topics to help your audience grow mentally, emotionally and spiritually through science and education.

Dec 30th
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Mikky

Guest speaker Paul is so insightful and engaging!

Aug 23rd
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Amr

it's a masterpiece not just for a mental health professional but to anyone needs to know how to think rationally.

Mar 13th
Reply

Arian

that was so delightful, my native language is not English however i could enjoy your speech

Jan 8th
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David Graber

excellent!

Dec 6th
Reply

Mckenzi Zogg

I am so glad you all did an episode on schema therapy. I left a comment on an earlier episode about about schema therapy with antisocial pd... great studies have come out in Sweden especially

Dec 8th
Reply

Shewikar El Bakry شويكار البكرى

this has been very enlightening.

Sep 14th
Reply

Mckenzi Zogg

I'd love to hear an episode on schema therapy... it has a lot of evidence with personality disorders

Jun 26th
Reply

C A.

Also, it's interesting that you acknowledge the importance of early childhood intervention on psychopathy but then ignore the potential impact of being raised in a patriarchal society.

Jun 2nd
Reply

C A.

You guys really need to read Cordelia Fine, also keep in mind not all men are born with "male" genitals and primates are not a mirror species for human behavior.

Jun 2nd
Reply (1)

Angelisa Lowry

Such a thoughtful and thorough layout. Thank you for pointing out why attachment and trauma are not a deciding factor regarding psychopathy.

May 26th
Reply

Deanna Friesen

In this episode, there was a book mentioned to download. How may I get the resources mentioned in the great podcast. I am a psych nurse in Vanciuver BC and found this so helpful and promising for less stigmatizing diagnoses. Thank You.

May 19th
Reply

Faby Angy

Thanks for listening. I really think this is the right step forward.

Jun 6th
Reply

Ankur Motwani

Does your iq improve or did you just get better at taking the tests ?

May 17th
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Ankur Motwani

It was a good and necessary episode, the host did true justice to the subject. Do watch till the end

Apr 16th
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Ankur Motwani

I found this channel today, and I am impressed already. Looking forward to listen more ! Thanks for the information.

Apr 12th
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Mechelle Marie

Amazing topic. Thank you for sharing your knowledge

Jan 23rd
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Kevin Carnahan

This was not a good episode. There was alot of discussion of opinions, broad generalizations, and over simplifications. There were almost no facts, studies or even expert census discussed. it was nice to hear the womans story but that was about it.

Nov 7th
Reply