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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In this episode, Dr. David Puder, alongside guests Rachel Blackston and Dr. Eric Bender, dives into the psychological insights presented in Pixar's Inside Out 2. Together, they explore the complex emotional world of adolescence, focusing on the challenges Riley faces as she navigates new emotions—like Anxiety, Envy, and Embarrassment—that reflect common experiences during teenage years. Through expert analysis, the conversation unpacks how these emotions influence identity formation, self-doubt, and social dynamics. The discussion also addresses the impact of childhood experiences, how adolescents process peer pressures, and the role of parental responses in supporting emotional growth. Join us as we delve into the film’s depiction of teenage mental health and its psychological accuracy, providing parents, therapists, and teens themselves with valuable takeaways on emotional resilience and self-discovery.

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

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Borderline Personality Disorder (BPD) is known for its complexity, but how should clinicians approach treatment? In this episode, Dr. Michael Cummings joins us to explore the role of medications in managing BPD, when to use them, and why psychotherapy remains the cornerstone of treatment. From pharmacotherapy to alternative approaches like exercise and omega-3s, we break down the latest evidence and offer practical insights for clinicians. Don’t miss this deep dive into managing one of psychiatry’s most challenging disorders.

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

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Join Dr. David Puder and renowned psychopharmacologist Dr. Michael Cummings as they dive deep into the complex relationship between psychiatric medications and weight gain. In this episode, they explore the metabolic challenges posed by antipsychotic medications, focusing on cutting-edge solutions like GLP-1 agonists. Whether you're a mental health professional or someone impacted by these medications, this conversation offers practical insights on how to manage medication-induced weight gain through diet, exercise, and pharmacological interventions. Learn how to tackle this growing issue in mental health care with a thoughtful, science-backed approach.

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

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In this episode, we explore the innovative work of Dr. Paul L. Wachtel, a leading psychologist known for his integrative approach to psychotherapy. Dr. Wachtel challenges single-framework therapy models, advocating for a flexible approach that draws from cognitive-behavioral, psychodynamic, humanistic, and other modalities. We discuss his concept of the "disavowed self"—the parts of oneself that are unconsciously denied—and how therapists can help clients reclaim these aspects to foster growth.

We also dive into how attachment theory and integrative methods can be used to treat anxiety, phobias, and interpersonal issues, providing practical insights for both therapists and those interested in understanding human behavior more deeply. Join us for an engaging conversation on advancing therapeutic practices.

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

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