What do you call someone who forgets you entirely, then confidently tells you something that never happened? That's a patient with Korsakoff's syndrome. They can hold a normal conversation with you, then forget you were ever there the moment you leave. Ask them to explain the gap, and they won't lie. They'll fill it with something that feels completely true.

In this episode, we explore Korsakoff's syndrome, picking up from the patient we met in episode 35. 

We cover how thiamine deficiency damages the brain's memory circuitry, why confabulation happens, and how ICD-11 classifies the condition differently from older systems. We also look at its relationship to Wernicke's encephalopathy, and the narrow treatment window that separates recovery from permanent amnesia.

Topics include the Wernicke-Korsakoff spectrum, the pathophysiology of thiamine deficiency and the brain's memory circuit, the clinical picture of anterograde amnesia and confabulation, ICD-11's classification of amnestic disorders, and emergency and long-term management.

Ideal for MRCPsych Part A revision, psychiatry trainees and anyone who wants to understand one of psychiatry's most striking examples of memory failure.

Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.10, and the ICD-11 classification of amnestic disorders.

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Have you ever driven somewhere familiar and arrived with no memory of the journey itself? Something in your mind was clearly steering the car. It just wasn't the part you'd call "you."

In this episode, we begin a new mini-series on states and levels of awareness. We start with the levels of consciousness themselves, from full alertness through the preconscious to the unconscious, contrasting Freud's original model with the modern cognitive unconscious. 

We then look at the evidence that unconscious processing genuinely happens, covering subliminal priming, implicit memory, automatic processing, and unconscious emotional responses in the brain.

Ideal for MRCPsych Part A revision, psychology students and anyone curious about how much of the mind operates outside awareness. 

Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.10.

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Why do some people recover from adversity while others do not? What does resilience have to do with this?

In this episode, we explore the psychology of resilience. We cover definitions of resilience, landmark research from developmental and clinical psychology, the factors that promote and undermine resilience, and the implications of resilience research for recovery-oriented psychiatric practice.

Topics include the distinction between resilience and invulnerability, the landmark Kauai longitudinal study, protective factors across biological, psychological and social domains, and the concept of post-traumatic growth.

Ideal for MRCPsych Part A revision, psychology students and anyone interested in what enables human beings to recover and flourish after adversity. Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9.

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Do you believe that what happens to you is within your control, or largely down to chance? The answer to that question shapes how you respond to stress, setbacks and illness.

In this episode, we explore three related concepts that illuminate individual differences in perceived control: Rotter's locus of control, Seligman's learned helplessness and Rosenbaum's learned resourcefulness.

Topics include the distinction between internal and external locus of control, the original animal experiments behind learned helplessness, the cognitive triad of helplessness, its relationship to depression, and the clinical implications of learned resourcefulness in rehabilitation and recovery.

Ideal for MRCPsych Part A revision, psychology students and anyone curious about the psychology of control and resilience. Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9.

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Stress is not something that simply happens to you. How you interpret and respond to a stressful situation is just as important as the situation itself.

In this episode, we explore Richard Lazarus and Susan Folkman's transactional model of stress and coping, one of the most influential frameworks in health psychology. We cover primary and secondary appraisal, the distinction between problem-focused and emotion-focused coping, and the clinical relevance of coping theory in psychiatric practice.

Topics include the role of cognitive appraisal in determining the stress response, adaptive versus maladaptive coping strategies, and the application of coping theory to therapeutic approaches including CBT and motivational interviewing.

Ideal for MRCPsych Part A revision, psychology students and anyone seeking to understand why the same event can devastate one person and barely affect another. Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9.

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Two people can experience the same stressful event and respond in completely different ways. One develops depression; the other seems unaffected. Why?

In this episode, we explore the factors that determine individual differences in vulnerability and resilience to stress. We cover biological, psychological and social vulnerability factors, and examine the landmark research of Friedman and Rosenman on Type A behaviour and coronary heart disease.

Topics include the stress-diathesis model, the Western Collaborative Group Study, the distinction between Type A and Type B personalities, Type D personality, and the clinical implications of personality and behaviour in cardiovascular and psychiatric risk.

Ideal for MRCPsych Part A revision, psychology students and anyone curious about what makes some people more resilient than others. Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9.

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What happens when trauma is not a single event, but the air someone has breathed their entire life?

In this episode, we explore complex PTSD. This is the ICD-11 diagnosis that captures the lasting impact of prolonged, repeated and inescapable trauma. We build on the core PTSD criteria from the previous episode. We focus on the additional features that define complex PTSD, why it is so often missed or misdiagnosed, and the phased treatment approach recommended by NICE.

Topics include disturbances in self-organisation, the distinction between complex PTSD and borderline personality disorder, the developmental context of complex trauma, and why stabilisation must come before trauma processing.

Ideal for MRCPsych Part A revision, psychiatry trainees and anyone working with persons who have experienced prolonged or interpersonal trauma.

Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9.

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Why does a sound, a smell or a flash of light have the power to pull someone back into the worst moment of their life, years after it happened?

In this episode, we explore post-traumatic stress disorder (PTSD) in depth. We cover the ICD-11 diagnostic criteria, the three core symptom clusters, and the neurobiology that explains why PTSD symptoms are so persistent and so difficult to simply talk yourself out of.

Topics include re-experiencing, avoidance and hyperarousal, the role of the amygdala, hippocampus and prefrontal cortex, the paradox of cortisol in PTSD, and evidence-based treatments including trauma focused-CBT, EMDR and pharmacological options.

Ideal for MRCPsych Part A revision, psychiatry trainees and anyone working with patients who have experienced trauma.

Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9, 3.5.1.13 and 3.9.5.

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Not all stress comes from outside events. Some of the most corrosive stress arises from within, when we are pulled in opposite directions at the same time.

In this episode, we explore the psychology of conflict and trauma. We cover the three classical types of motivational conflict described by Kurt Lewin, the psychological impact of traumatic experience, and the relationship between trauma and post-traumatic stress disorder (PTSD).

Topics include approach-approach, avoidance-avoidance and approach-avoidance conflict, the diagnostic features of PTSD, and the neurobiological mechanisms underlying traumatic memory.

Ideal for MRCPsych Part A revision, psychology students and anyone seeking to understand why trauma leaves such a lasting mark. Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9.

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Can a single life event make you physically ill? Research suggests it can, and the evidence is more precise than you might expect.

In this episode, we explore the social origins of stress. We cover Holmes and Rahe's Social Readjustment Rating Scale, the landmark studies linking life events to illness onset, and Kanner's research on daily hassles and uplifts as independent predictors of wellbeing.

Topics include the concept of the life change unit, the distinction between acute and chronic stressors, the difference between negative and positive life events as stressors, and the clinical relevance of life event assessment in psychiatry.

Ideal for MRCPsych Part A revision, psychology students and anyone curious about why stress gets under the skin. Aligned with the Royal College of Psychiatrists MRCPsych Part A syllabus, paragraph 1.1.9. 

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