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Eating disorders are among the most serious of mental health challenges, and yet are mired in stereotypes, stigma and misunderstanding.  Clinical Psychologist Dr. Meagan Gallagher joins us for an in-depth discussion of eating disorders which covers:  

• How Dr. Gallagher became interested in treating eating disorders from a personal and professional perspective
• An in-depth clinical consideration of the most common eating disorders in adults
• Conceptualizations around the clinical presentation of eating disorders, including misleading stereotypes
• Core-interventions/phased-treatment approaches for eating disorders
• Opportunities & caveats around the integration of family members into treatment
• Managing the special challenges with respect to insight/willingness that can at times characterize eating disorders
• Effectiveness of available treatment and how to shape expectations about outcomes for client and clinician alike
• Addressing "social contagion" considerations around eating disorders as well as navigating unhelpful online influences and communities with respect to eating disorders
• How to help children and adolescents think critically about societal messaging with respect to body types, body ideals etc.  

Dr. Meagan Gallagher is a clinical psychologist who works with adolescents, adults, couples, and families who are experiencing a range of difficulties related to mental health concerns.  She provides psychological assessments and treatment using evidence-based approaches including Cognitive Behavioural Therapy (including Exposure and Response Prevention Therapy and Prolonged Exposure for Post Traumatic Stress Disorder), Emotionally Focused Therapy, Dialectical Behaviour Therapy (DBT) and Mindfulness. Dr. Gallagher has specific interests and extensive experience in the assessment and treatment of Eating Disorders and body image concerns, Anxiety Disorders, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, Mood Disorders, and adolescent mental health. She is currently in private practice at Integrated Wellness Ottawa.

https://integratedottawa.ca

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Helping clients to develop their own solutions to challenging problems as well as work through a variety of perspectives when considering an important decision are among the most important functions of therapy.  Building on their Applying the 80-20 Rule to CBT episode of Thoughts on Record, OICBT clinicians Drs. Jeff Perron, C.Psych & Pete Kelly, C.Psych explore effective decision making and problem solving from a CBT lens.  In this wide-ranging discussion they cover internal & external factors influencing decision making and problem-solving including:   

• Core beliefs 
• Values & resolving conflict between values
• Self-justification & cognitive dissonance
• Actor-observer bias/fundamental attribution error
• Sunk cost fallacy
• Endowment bias
• Hedonic adaptation
• “Summit fever”/overidentification of goals    
• Affective Realism/Cognitive distortions
• Learning how to engage in constructive conflict 
• Being effective vs. being right
• Decoding hidden incentives/explanations for the behaviour of others
• Mentalizing/Empathy
• A policy of radical personal honesty around observed patterns of behaviour
• Acceptance to reduce suffering

In addition, they review practical tips borne from clinical experience to implement the concepts, tools and strategies described above.   

Dr. Jeff Perron provides clinical psychology services to adults, with a particular focus on the areas of mood and anxiety disorders.  Guided by client goals and presenting concerns, he applies the range of evidence-based Cognitive Behavioural Therapies, including Schema Therapy and Acceptance and Commitment Therapy.  Dr. Perron completed his Ph.D. in Clinical Psychology at the University of Ottawa.  He completed his doctoral residency at the OICBT and his doctoral thesis research focused on the development of a measure related to assessment of readiness to change.  He also holds an MBA from Wilfrid Laurier University and has a background in Human Resources.

https://www.ottawacbt.ca/dr-jeff-perron

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Psychotherapy can be a powerful & transformative experience for the clinician and client alike.  In this episode psychotherapist and author Nicole Arzt, M.S., L.M.F.T.  discusses her new book Sometimes Therapy is Awkward: A Collection of Life Changing Insights for the Modern Clinician.  In this wide-ranging conversation a number of topics central to the process of therapy are addressed including: 

• identifying and managing impostor syndrome/insecurity as a therapist
• reflections on how the provision of psychotherapy can change the therapist
• cultivating an identity as a growth-orientated therapist
• navigating termination and aiming for the "good-enough" good-bye
• managing compassion fatigue and burnout
• the unique challenges faced by new therapists with thoughts on how to best cope
• a brief consideration of how to manage the distress associated with navigating suicide 
• leveraging process related factors and the clinician's own emotional reaction in session to improve their interventions 

Nicole Arzt is a licensed marriage and family therapist specializing in providing psychotherapy to individuals, families, and groups struggling with substance use disorders and psychiatric illnesses. She received her master’s of science degree from California State University, Long Beach in 2014. She has extensive experience working in a variety of dual-diagnosis treatment centers, providing services for all levels of care from detoxification to long-term outpatient therapy. Nicole currently works full-time as a therapist, using psychodynamic and humanistic work. A passionate writer, she has authored several scholarly articles, blog posts, and professional research centered on addiction and mental health.

https://www.souloftherapy.com/
https://psychotherapymemes.com/

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Maligned and misunderstood, addiction can present among the greatest clinical challenge to mental health professionals.  In addition, the stigma and shame associated with addiction is a frequent and strong barrier to clients seeking services.  Teaching professor, Chair of the Department of Neuroscience of Carleton University and host of the podcast Minding the Brain Dr. Kim Hellemans joins host Dr. Pete Kelly, C.Psych to discuss:  

• how Dr. Hellemans became interested in the study of addiction
• current thinking around the definition of addiction
• the neurobiological basis of addiction, considering both subcortical and cortical processes
• psychological factors that influence addiction including trauma, state dependent learning, environmental conditions & social connectivity
• is there such a thing as an "addictive personality"?
• fact and fiction around addiction related to behaviour such as gambling, sex, gaming, eating & work
• harm reduction through a neurobiological lens
• some thoughts on how to leverage knowledge of the neuroscience of addiction to reduce stigma and increase access to care

Dr. Kim Hellemans is a teaching professor and the current Chair of the Department of Neuroscience at Carleton University. She received her PhD from Queen's University, where her research focused on understanding the biological basis of drug addiction. She later went on to complete post-doctoral positions at Cambridge University and University of British Columbia prior to joining Carleton University in 2008. Dr. Hellemans has received several prestigious awards for her passion and dedication to university teaching. Outside of the classroom, she's the co-host of the popular podcast, Minding the Brain.

https://mindingthebrainpodcast.com/

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Forgiveness has been defined in many ways by many traditions. However, a powerful and clinically relevant way of defining forgiveness is as a suite of skills that can be learned to promote a sense of self-efficacy, emotional effectiveness, physical and emotional well-being & resolution of grieving in the aftermath of betrayal, wrongdoings and even trauma.  In this episode with author, teacher, and clinician Dr. Fred Luskin, we discuss the clinical and practical implementation of his forgiveness model as outlined in his best-selling book Forgive For Good.  In this conversation we review:

• the Forgive for Good definition of forgiveness
• the preconditions of forgiveness, including grieving
• how & when a grievance has formed and when this becomes a barrier to moving forward
• forgiveness as a strategy for resolving complicated grief
• the definition and application of the concept of "unenforceable rules"
• the definition and application of the concept of  the "personal and impersonal pain" dialectic and how this concept is critical to conceptualizing our hurts  
• caveats and considerations around forgiveness in the context of trauma
• a brief consideration of the role of forgiveness in helping address clinician burnout/compassion fatigue.

Fred Luskin, Ph.D. is Director of the Stanford Forgiveness Project, an ongoing series of workshops and research projects that investigate the effectiveness of his forgiveness methods on a variety of populations. The forgiveness project has successfully explored forgiveness therapy with people who suffered from the violence in Northern Ireland, Sierra Leone as well as the attacks on the World Trade Center on 9/11. In addition his work has been successfully applied and researched in corporate, medical, legal and religious settings. He currently serves as a Senior Consultant in Health Promotion at Stanford University and is a Professor at the Institute of Transpersonal Psychology. He presents lectures, workshops, seminars and training on the importance, health benefits and training of forgiveness, stress management and emotional competence throughout the United States. He is the author of Forgive for Good: A Proven Prescription for Health and Happiness and Stress Free for Good: Ten Proven Life Skills for Health and Happiness with co-author Kenneth Pelletier, Ph.D.

https://learningtoforgive.com/

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Despite its many benefits, psychotherapy can understandably be an intimidating and scary proposition for many.  In this special "fireside chat" edition of Thoughts on Record, host Dr. Pete Kelly, C.Psych  walks you through:   

• common reasons why people don’t, won't (or can’t) engage in therapy and some food for thought around how to think through these challenges
• some of the top reasons to consider engaging in therapy
• observations around what allows someone the best chance to benefit from therapy
• what to look for in a therapist
• what to expect when you start therapy
• what to expect during therapy
• some additional thoughts on the opportunity that therapy presents

While crafted for those listeners who have been thinking about therapy, but who are scared, on the fence or maybe just a little curious and want to learn more, we're also hopeful this podcast might give junior and established clinicians alike some new ideas for thinking about how to talk about therapy with new or prospective clients.

Dr. Pete Kelly is a Clinical Psychologist and Executive Director of Innovation at the Ottawa Institute of Cognitive Behavioural Therapy.  He provides individual and group treatment to adults for mood and anxiety disorders and is actively involved in developing innovative clinical programming to increase the accessibility and effectiveness of psychological therapies.  He is a Clinical Professor in the School of Psychology at the University of Ottawa and Adjunct Research Professor in the Department of Neuroscience at Carleton University. In addition to publishing scientific papers and delivering public lectures, Dr. Kelly is co-author of the clinician manual “Treating Psychosis: A Clinician's Guide to Mindfulness, Acceptance, and Compassion-Based Approaches within the Cognitive Behavioral Therapy Tradition”. He is also co-author of the Canadian Adaptation of the textbook “Research Methods in Psychology” for Oxford University Press.  Finally, he hosts and produces the Ottawa Institute of Cognitive Behavioural Therapy’s podcast Thoughts on Record. 

Evolutionary biologist Bret Weinstein, Ph.D. joins host Pete Kelly, Ph.D., C.Psych for a wide-ranging discussion around how the understanding of ourselves from an evolutionary lens might help us to build the awareness needed at both the level of the individual as well as the collective, to identify, manage (and even solve) our most emergent and pressing challenges.  In this discussion they explore in depth:

• some of our more challenging characteristics as a species and the selection pressures that led to the evolution of these traits.
• Drs. Weinstein & Heyings' model of the interplay between consciousness & culture.
• the propensity for humans - both at the level of the individual as well as collectively - to view themselves as immune to maladapative, but predictable historical patterns.   
• an evolutionary lens on leadership and engaging in difficult conversations in the service of truth mapping and problem-solving.  
• conceptualization of mental illness from an evolutionary perspective, with a focus on evaluation of symptoms in context as well as relative to historical selection pressures vs the unique challenges of modernity.
• the value of utilizing all emotions - including those which are unpleasant - as problem-solving tools as well as how psychotherapy can assist in this respect.   
• evolutionary perspectives on human sexuality and sexual competition.
• Dr. Weinstein's application of our understanding of biological senescence (i.e., aging) to the understanding of the arc of societies as well as the lives of individuals (and how we might avoid the downfalls of such a trajectory).      
• a brief consideration of the rise of Trump through an evolutionary lens.
• Dr. Weinstein's advice and perspective for transcending the challenges of our evolutionary legacy to address the existential threats faced by all of us at the present moment.  

Bret Weinstein has spent two decades advancing the field of evolutionary biology, earning his PhD at the University of Michigan, before teaching at The Evergreen State College for 14 years, from which he resigned his tenured position in 2017. He has developed a new Darwinian framework based on design trade-offs, and made important discoveries regarding the evolution of cancer, senescence and the adaptive significance of moral self-sacrifice. He is currently working to uncover the evolutionary meaning of large scale patterns in human history, and seeking a game theoretically stable path forward for humanity. With his wife, Heather Heying, he is co-writing A Hunter-Gatherer’s Guide to the 21st Century, and is the host of Bret Weinstein’s DarkHorse podcast.

https://www.youtube.com/BretWeinsteinDarkHorse
https://twitter.com/BretWeinstein
https://bretweinstein.net/

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Eating disorders such as anorexia nervosa can reflect among the most severe and debilitating forms of mental illness.  In fact, anorexia nervosa has the highest mortality rate of any form of mental illness and unfortunately for a subset of clients, all current "gold standard" treatments can prove ineffective.  Dr. Blake Woodside, MD, a pioneer in the revolutionary use of deep brain stimulation for treatment resistant eating disorders joins us to discuss: 

• the history and development of DBS 
• how Dr. Woodside  personally became interested in DBS for eating disorders
• a description of the clinical presentation and prognosis of severe anorexia nervosa 
• the brain areas are typically targeted in DBS and possible mechanism of action
• inclusion/exclusion criteria for a client being considered as a candidate for DBS
• informed consent in the context of DBS 
• how the DBS procedure is undertaken (client preparation, client experience during surgery, recovery etc.)
• combining DBS combined with psychotherapy and medication 
• a review of the typical response rate to DBT
• philosophical considerations around DBS with respect to free will, ethics, human performance etc.  
• future developments and technological advances in DBS and associated techniques

Dr. Blake Woodside’s specialty in psychiatry is the treatment of eating disorders in adults, and family therapy of adolescent anorexia nervosa. He is Medical Director Emeritus, Program for Eating Disorders at the Toronto General Hospital, where he led the inpatient service for 25 years, and Professor in the Department of Psychiatry at the University of Toronto.  Dr. Woodside is actively involved in research, presently focusing on novel treatments in eating disorders, including Deep Brain Stimulation, Repetitive Transcranial Magnetic Stimulation, and Family-Based Therapy. He has also served in various capacities for the Canadian Medical Association, and the Canadian Psychiatric Association.

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Unraveling the mystery of consciousness, including experiences nested within consciousness such as emotions reflects the leading edge of inquiry in a variety of fields including neuroscience, psychology and philosophy.   Preeminent neuroscientist, author & musician Joseph LeDoux, PhD., a pioneer in the field of brain mechanisms of memory and emotion joins host Dr. Pete Kelly, C.Psych to discuss: 

• Dr. LeDoux's model of emotions, including a comprehensive tracing of the perception of a stimulus through the central nervous system all the way through to the construction of the conscious experience of an emotion.  
• the importance of a sense of self to the experience of emotions.
• the universality of the need to navigate threat contrasted with the very individual or even culturally bound experience of the emotion of fear
• construction of emotional schemas 
• a brief review of the different forms and layers of consciousness
• implications of Dr. LeDoux's model for improving the effectiveness of psychotherapy, particularly exposure based-therapy.
• consideration of how subcortical, unconscious processes interact to produce conscious states from a therapeutic lens.  
• advantages and disadvantages of the evolution of consciousness with a consideration of the implications for the fate of humanity.  

Dr. Joseph LeDoux is the Henry and Lucy Moses Professor of Science at NYU in the Center for Neural Science, and he directs the Emotional Brain Institute of NYU and the Nathan Kline Institute. He is also a Professor of Psychiatry and Child and Adolescent Psychiatry at NYU Langone Medical School. His work is focused on the brain mechanisms of memory and emotion and he is the author of The Emotional Brain, Synaptic Self, Anxious and The Deep History of Ourselves. LeDoux has received a number of awards, including William James Award from the Association for Psychological Science, the Karl Spencer Lashley Award from the American Philosophical Society, the Fyssen International Prize in Cognitive Science and the American Psychological Association Distinguished Scientific Contributions Award among many, many others.  His book Anxious received the 2016 William James Book Award from the American Psychological Association. LeDoux is a Fellow of the American Academy of Arts and Sciences, the New York Academy of Sciences, and the American Association for the Advancement of Science, and a member of the National Academy of Sciences. He is also the lead singer and songwriter in the rock band, The Amygdaloids and performs with Colin Dempsey as the acoustic duo So We Are.

https://joseph-ledoux.com
https://www.amygdaloids.com/
http://www.soweare.net

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Many psychotherapists have a number of clients who are taking psychotropic medications to address symptoms of mental illness; however, focused and in-depth didactic training in psychopharmacology as well as how to conceptualize the use of pharmacological strategies in the context of psychotherapy is not a core component of many graduate psychotherapy programs.  Dr. Cary Kogan, C.Psych, a clinical psychologist with a Post-Doctoral Master's degree in clinical psychopharmacology, shares his insights around:

• the value in training in pharmacology for psychologists
• the current prescribing environment for psychologists in Canada & the United States
• current nomenclature/classification around psychotropic medications
• considerations around the use of psychotropic medication e.g., method of administration, side-effects, brand vs. generic etc. 
• current evidence & risks around medications with antidepressant effects
• brief consideration of psychedelic compounds as therapeutic agents
• informed consent around the use of psychotropic medication
• considerations around combining psychotherapy & pharmacological strategies
• the complex relationship between diagnostic systems, prescription practices and conceptualization of mental illness

Episode Disclaimer:  Any discussion of medical treatment is intended as information only and should not be used as a basis for making treatment decisions without consulting with a licensed professional.

Cary Kogan earned his Ph.D. in clinical psychology from McGill University and Post-Doctoral Master’s degree in clinical psychopharmacology from Fairleigh Dickinson University in the USA. He is currently Professor of Clinical Psychology in the School of Psychology at the University of Ottawa where he also serves as Director of the Centre for Psychological Services and Research, a community-based mental health training centre. Dr. Kogan teaches at the undergraduate and graduate levels including courses on psychopathology and psychopharmacology. His research interests include classification of psychopathology and translational neuroscience with a special focus on neurodevelopmental disorders. Dr. Kogan is a consultant to the World Health Organization, Department of Mental Health and Substance Abuse, for the revision of the Mental, Behavioural and Neurodevelopmental Disorders chapter of the International Classification of Diseases (ICD). He has contributed to the development, testing, and international implementation of the clinical descriptions and diagnostic guidelines for mental health professionals.