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.

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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.

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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.

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Can cold exposure improve your mental health? In this episode, we explore the science behind cold therapy methods like ice baths, cryotherapy, cold-water swimming, and cold showers. Backed by research, we dive into the physiological and psychological effects of cold exposure, including its impact on mood, anxiety, dopamine, norepinephrine, and stress resilience.

We discuss historical practices, benefits for mental and physical health, and common misconceptions around claims like immune boosting and inflammation reduction. Learn practical tips, safety precautions, and how cold immersion could fit into your mental health or wellness routine.

Whether you’re curious about the Wim Hof Method, the dopamine-boosting effects of cold plunges, or the latest studies on cold exposure’s antidepressant potential, this episode offers insights you won’t want to miss.

By listening to this episode, you can earn 1.5 Psychiatry CME Credits.

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In this episode of the Psychiatry & Psychotherapy Podcast, Dr. David Puder is joined by Mark Ruffalo to dive deep into the complexities of borderline personality disorder (BPD). Together, they unpack Donald Burnham’s influential 1966 paper on splitting and identity diffusion, exploring themes of self-concept, relational dynamics, and the therapeutic challenges posed by BPD patients.

Learn how splitting impacts interpersonal relationships and therapeutic teams, the historical evolution of BPD from "pseudoneurotic schizophrenia" to a recognized DSM diagnosis, and the significance of psychodynamic and mentalization-based therapies in treatment.

Key topics include:

• The history of BPD diagnosis and theory
• Splitting and its effects on therapy teams and relationships
• Identity diffusion and its manifestations in gender, sexuality, and self-worth
• The role of childhood trauma, attachment, and genetic factors in BPD
• Practical insights for clinicians working with complex personality dynamics

Whether you’re a mental health professional, a student of psychiatry, or someone seeking a deeper understanding of BPD, this episode offers rich insights and evidence-based approaches for navigating this challenging and often misunderstood condition.

By listening to this episode, you can earn 1.75 Psychiatry CME Credits.

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Can exercise truly rival medications and therapy for treating depression? In this episode, Dr. David Puder, Dr. Nicholas Fabiano, and Dr. Brendon Stubbs dive deep into the science of physical activity as a treatment for mental health. Discover the unique antidepressant mechanisms of exercise, how it compares to traditional treatments, and practical tips for prescribing it to patients. Learn about the optimal types, doses, and benefits of exercise, including its impact on mood, resilience, and cognitive health.

By listening to this episode, you can earn 1.75 Psychiatry CME Credits.

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In this episode, Dr. David Puder sits down with Dr. Stijn Vanheule, professor of clinical psychology and psychoanalysis, to challenge misconceptions about psychosis and explore paths to understanding and recovery. They discuss psychosis as more than a clinical label, delving into its connection to existential struggles and creative expression.

Dr. Vanheule explains primary-process thinking, how traumatic events can disrupt the mind's coherence, and the importance of empathic listening in therapy. Drawing on examples like Carl Jung's Red Book and Annie Rogers' creative processes, the conversation highlights the therapeutic potential of integrating psychoanalysis, creativity, and supportive environments.

Whether you’re a mental health professional, caregiver, or curious listener, this episode provides insights into how psychotic experiences can be understood, respected, and addressed through innovative approaches.

By listening to this episode, you can earn 1.25 Psychiatry CME Credits.

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In this episode, Dr. David Puder dives deep into the world of Obsessive-Compulsive Disorder (OCD) with renowned expert Dr. Fred Penzel, who brings over 43 years of experience to the table. Together, they explore groundbreaking approaches to treating OCD, including Exposure and Response Prevention (ERP), cognitive restructuring, and embracing uncertainty. Dr. Penzel shares fascinating insights into the neurobiology of OCD, the cycle of intrusive thoughts and compulsions, and effective strategies for lasting recovery.

Whether you're a clinician seeking best practices or someone navigating OCD, this episode offers a wealth of practical tools, compelling stories, and hope. Uncover why OCD is called the "doubting disease" and how evidence-based methods can break its grip. This is more than a podcast—it's a roadmap to understanding and overcoming one of the most challenging mental health conditions.

By listening to this episode, you can earn 1.25 Psychiatry CME Credits.

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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. 

By listening to this episode, you can earn 1.75 Psychiatry CME Credits.

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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.

By listening to this episode, you can earn 1 Psychiatry CME Credits.

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