How to Be Patient

By Human ContentMedicine Health & Fitness Mental Health Education Self-Improvement

How to Be Patient episodes

September 28 The Theory of the Crunch: Holding Difficult Dynamics in Therapy
In today’s episode, Preston and Margaret discuss the psychotherapy paper The Theory of the Crunch, by Paul Libby, a psychoanalyst. In this episode and in the paper, the idea of creating a containing environment, repetition compulsion, and ways of navigating difficult interpersonal dynamics are discussed. In this episode, a more expansive, compassionate frame will be introduced both for the therapist and patient to understand how to make it through confusing and sometimes painful clinical work.

Paper: The Theory of the Crunch by Paul Libby Russel: https://www.proquest.com/openview/c5d466aa2f6d7bcd126f98b6591861f7/1?pq-origsite=gscholar&cbl=32944

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Produced by Dr Glaucomflecken & Human Content
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1 hr
September 21 Psychiatric Effects of GLP-1s (What We Know So Far)
In this episode, Margaret and I take on the en vogue topic of GLP-1s. They have been utilized for T2DM for several years and just recently took center stage in the zeitgeist for weight loss (medically indicated or otherwise). Today, we will break down possible risks to mental health in patients using these medications and, on the flipside, potential areas where we could possibly use GLP-1s primarily to treat mental illness.
Paper used:
Sa B, Maristany A, Subramaniam A, et al. Psychiatric effects of GLP-1 receptor agonists: A systematic review of emerging evidence. Diabetes Obes Metab. 2026;28(1):50-59. doi:10.1111/dom.70198

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59 min
September 14 Nuances in Prescribing Antidepressants
In this episode, Margaret and Preston present how two psychiatrists think about prescribing medications for depression. Using different common clinical scenarios, they discuss standard clinical guidelines, navigating weight gain and loss with SSRIs, augmentation of SSRI’s, and sexual side effects.
See notes below for recommendations in the episode.
VA/DoD MDD treatment guidelines, 2022
https://www.healthquality.va.gov/guidelines/MH/mdd/
American College of Physicians Depression
https://www.acpjournals.org/doi/10.7326/M22-2056
Weight Change and Antidepressants
https://pubmed.ncbi.nlm.nih.gov/33022115/
Pregnancy/Perinatal/Breastfeeding
https://womensmentalhealth.org/specialty-clinics/psychiatric-disorders-during-pregnancy/

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Produced by Dr Glaucomflecken & Human Content
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59 min
September 07 Psychiatric Roots in Greek Mythology
The Greeks described two kinds of madness, and both are fun to talk about on our pod. Inspired by the recent hullabaloo around The Odyssey, we are going to be breaking down the DSM-V diagnoses we see in the series and run through the historical roots and the stories of what we see today in mental health.

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1 hr 7 min
August 31 Climate Change Impacts on Mental Health with Child Psychiatrist & Pediatrician Elizabeth Pinsky, MD
In today’s episode, Margaret and Preston are joined by pediatrician and child psychiatrist Elizabeth Pinsky, MD. Dr. Pinsky works as a pediatric consult-liaison psychiatrist at Massachusetts General Hospital and her clinical interests lie at the intersection of child mental and physical health, including childhood trauma associated with medical care, fostering resilience in medically ill children, and climate change.

In this episode, we discuss the current understanding of climate change on mental health and wellbeing for all, why “climate anxiety” locates the problem in the wrong place, and how healthcare workers can help in collective action to improve the climate’s health to improve all our health.

Noted articles:

Thermoregulation in Schizophrenia as a sign article: Redundant clothing: A readily observable marker for schizophrenia in the psychiatric emergency room population. ⁠⁠https://www.sciencedirect.com/science/article/abs/pii/000579169390007J⁠⁠

Climate communicator recommended: ⁠⁠https://www.katharinehayhoe.com/⁠⁠

Resources Referenced:
⁠⁠https://www.climatepsychology.us/⁠⁠
⁠⁠https://www.climatepsychiatry.org/⁠⁠

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55 min
August 24 Lessons from Improv Comedy
Laugh all you want (please laugh it’s supposed to be funny), Preston has been doing improv from the last year and he has some thoughts. Not just “yes ands” about how it makes him a better doctor, and he is dragging Margaret into the mix starting off with some improv style warm ups and ending with a philosophical commentary about the stage we all perform on. I don’t know why I am talking about Preston like I am not the one writing this. Hi it’s me, Preston. Enjoy the episode!

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1 hr 10 min
August 17 Kung Fu Panda & Residency: Growth Mindset
Margaret is back and today our episode pulls themes from Carol Dweck’s work and book Growth Mindset, as well as a favorite sophisticated film: Kung Fu Panda. In this episode, Margaret and Preston discuss a frame to make sense of the obstacles we meet as we change levels of training, weather you’re starting med school, doing a post doc, or changing jobs. We walk through phases of growing, including failing, flailing, and flourishing, and give examples along the way from our growth-minded Panda friend.
Check out some info on Dr. Dweck’s work:
https://ctl.stanford.edu/students/growth-mindset
Check out a paper as well from a few years ago on limitations/evolving learning on growth mindset as a frame (we love nuance here):
Yeager DS, Dweck CS. What can be learned from growth mindset controversies? Am Psychol. 2020 Dec;75(9):1269-1284. doi: 10.1037/amp0000794. PMID: 33382294; PMCID: PMC8299535.

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56 min
August 10 THROWBACK: Alcohol: Examining Alcohol culture, history, and use disorder (Season 1 Episode 15)
In Episode 15, Preston and Margaret open a bottle—of questions, stories, and science—about alcohol use disorder. What do we get wrong about “moderate” drinking? Why is detox more dangerous than most people realize? And how does alcohol quietly reshape identity, relationships, and the brain itself? With their signature blend of honesty and humor, they explore the unexpected ways drinking shows up in medicine, the myths that keep us stuck, and the messy, meaningful path to redefining recovery.

Takeaways:
What if “just a drink” isn’t so simple? Preston and Margaret explore how subtle patterns can blur the line between social drinking and something more.

Could quitting be more dangerous than drinking? There’s a reason detox needs to be taken seriously—and it’s not what you think.

What does alcohol really do to your brain? Let’s just say it’s a little more complicated than relaxation and red wine.

Why don’t we talk about medication for alcohol use disorder? The answers are as cultural as they are clinical.

Is recovery a destination—or something else entirely? Margaret and Preston unpack a version of success that doesn’t always fit the script.

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Produced by Dr Glaucomflecken & Human Content
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1 hr 35 min
August 03 Sex Differences in Aging Cognition with Dr. Sullivan
In today’s episode we bring on Dr. Campbell Sullivan, PsyD to discuss the interesting field of neuropsychology, a complicated niche that focuses on eliciting deficits in cognition across patters of disease. We discuss the triumphs of her field as they collaborate with both psychiatry and neurology and then get into the places she sees room for improvement, particularly in how we assess and treat cognition in the aging female brain.

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Produced by Dr Glaucomflecken & Human Content
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53 min
July 27THROWBACK: The Lithium Episode (Season 2 Episode 14)
In this preston-led episode, we take a deep dive into the history of lithium and its use in psychiatry. But because Preston is very literal, we are starting at the very beginning, inside of stars where lithium was formed at the beginning of the universe. Then we will follow this wonderful atom through history and past its FDA approval in 1970 to where we are today.

Takeaways:
Lithium was once sold in Seven Up as a mood-lifting ingredient—but the consequences were messy.

A forgotten Australian psychiatrist helped launch lithium into psychiatry with groundbreaking trials.

Despite its toxicity risks, lithium remains the gold standard for reducing relapse and suicidality.

U.S. psychiatrists resisted lithium for decades—even as Europe embraced it.

Preston and Margaret debate lithium’s place today: miracle stabilizer or underused relic?
Citations:
⁠https://www.sciencedirect.com/science/article/abs/pii/0025556484901160⁠
Shorter E. The history of lithium therapy. Bipolar Disord. 2009 Jun;11 Suppl 2(Suppl 2):4-9. doi: 10.1111/j.1399-5618.2009.00706.x. PMID: 19538681; PMCID: PMC3712976.⁠https://pmc.ncbi.nlm.nih.gov/articles/PMC3712976/⁠
Fowler, Gene. Crazy Water: The Story of Mineral Wells and Other Texas Health Resorts. No. 10. TCU Press, 1991.

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Produced by Dr Glaucomflecken & Human Content
Get in Touch: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠howtobepatientpod.com⁠⁠⁠⁠⁠⁠⁠⁠

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1 hr 17 min

About How to Be Patient

From the publisher's feed

You may have noticed a new trend lately. Everyone is loud and proud about their mental health struggles (and thank goodness)! For practitioners, this movement is as exciting as it is frustrating. As each mental health taboo falls by the wayside as it enters the cultural zeitgeist, a new aspect of our specialty thus emerges. One we just don’t have enough hours in the day to keep track of, let alone engage with. From better understanding our patients’ (and our own) relationships with their conditions in a changing world, it’s more important than ever that we learn: HOW TO BE PATIENT!