Episodes

Margaret and I pivot into mentor mode a little in this episode, it’s targeted towards medical students and the vicissitudes of the match. We know these are tough times and we wanted to share some advice about what to look for in a psych program and how to pick a place to train that is right for you. We also debrief the end of season 2 and take a wrap on 40 episodes! As always, thank you for listening!

By popular demand, Margaret and Preston are back with another therapy episode. The topic this week? Acceptance and Commitment Therapy (ACT), a third wave behavioral therapy that Margaret happens to be trained in and love for her patients and her own life. In this episode we talk about the founder of ACT and its roots in behaviorism, what an ACT therapist “sounds like”, and the 6 core processes of psychological flexibility that encompass what this type of therapy does. Finally, Margaret and Preston go through their own values, and try to apply the ACT principles to two particular problems in their own lives.

In this episode, we bring on Kristin Flanary, who is currently doing her own investigation into dissociations associated with trauma from both her own experience as a survivor and as an academic. We discuss the current media landscape of trauma and dissociation, the neurological mechanisms of dissociation, and therapeutic approaches clinicians can use with a patient who is experiencing dissociation.

Today we are joined by the host of the “calling in sick” a pod run by our good friend Alexandra Wildeson (familiarly) to discuss the rigamoroll that is chronic pain and navigating the healthcare system through the eyes of a patient with debilitating conditions. Alex shares her story from Investment banker, to patient to podcaster all the while coloring things with her own levity and resilience.

This episode is a slight excursion from our regularly scheduled program. Today we are chatting with Will Flanary, who is in many ways our content “dad” if you will. We will talk about the art of including humor into our daily practive, when it goes right, when it goes left, and where we go from here. Dr. Glaucomflecken also has some fun and new projects he’d like to share with you at the end.

Margaret and I are back with part two of our conversation with Dr. Drew Ramsey and this time, things get personal. I volunteered my real-life food log for a full nutritional psychiatry breakdown… and let’s just say my “ultra-processed protein” lifestyle did not escape unscathed.What started as a casual diet review turned into something deeper. A mentoring session about joy, creativity, and what it actually means to feed your brain. Margaret brings her psychodynamic insight, Dr. Ramsey brings the science, and I bring… a whole lot of protein powder and self-reflection.If you’ve ever tried to optimize your health but ended up missing the soul in your routine, this episode is for you.

We sat down with Dr. Drew Ramsey to talk about something we all think we understand and don’t: how food shapes mood. In Part 1, we get practical and personal: what to reach for when you’re anxious, what to cook when you’re depressed, and how to think about nutrition when you’re busy, broke, or just not in the headspace to sauté anything. We talk simple swaps, what actually belongs on a “brain food” plate, and why perfection is the enemy of getting fed.

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.

This week, Margaret and I sat down with Dr. Jhilam Biswas, psychiatrist and expert on the intersection of law and mental health, for one of the hardest—and most important conversations we’ve had on the show. Together, we take a close look at how our justice system responds to mental illness: what happens when people in crisis are incarcerated instead of cared for, and how the prison system has become a stand-in for mental health treatment in the U.S.Dr. Biswas helps us unpack the reality of solitary confinement, forced treatment, and the impossible choices clinicians face when caring for patients inside a system built for punishment, not healing. Alongside Margaret, I reflect on the human cost—on families, on providers, and on the people trapped in cycles of crisis and incarceration.This isn’t just a policy issue—it’s a deeply personal one. And it’s urgent.

What is aphasia, really and what happens when your brain no longer cooperates with your ability to speak or understand language? In this episode, Preston and Margaret tackle the messy, frustrating, and often isolating world of language disorders, focusing on the real-life implications of aphasias.They walk through the clinical causes, what it looks like day-to-day, and how aphasia differs from other speech and cognitive issues. Along the way, they share stories of miscommunication, explore the frustrations of being misunderstood, and dig into how patients and clinicians can better work together when words are hard to find.

Is it all in your head or is pain more complex than we’ve been led to believe? In this episode, Margaret and I dig into the psychological and biological factors that shape our experience of pain, including how the brain processes physical discomfort, the emotional toll it takes, and what role medications actually play. We also share stories from our own lives and clinical work that highlight how pain shows up in complicated, often misunderstood ways. If you've ever wondered why your body hurts when your heart is breaking, or why painkillers don’t always work, this one’s for you.

Margaret took the captain’s chair for this one, and I was just along for the ride—straight into the deep waters of psychodynamic and psychoanalytic therapy. We start with the basics: what do these words actually mean, and why do they still make some clinicians roll their eyes while others swear by them? From Freud’s infamous couch to modern relational therapy, we unpack the myths, the methods, and the mysteries that still define this approach.Along the way, we wrestle with big questions: What’s really happening in the therapeutic relationship? Why does transference matter? And is there value in a therapy that sometimes feels more like philosophy than science?And because talking about it wasn’t enough, we try it on for size—running a live role-play where I attempt a psychodynamic formulation in real time. (Spoiler: it’s as messy and awkward as you’d imagine, but also revealing in ways I didn’t expect.)This isn’t a lecture or a history lesson. It’s us exploring why psychodyn…

This episode might feel like a gut punch, in the most important way. Margaret and I sat down with Alyson Stoner to talk about what it means to be raised in the spotlight, what happens when systems prioritize performance over people, and how we reckon with that legacy in healthcare. There’s a vulnerability here that caught me off guard and I think that’s the point. If you’ve ever wondered what lies beneath the polished performances we all grew up watching, this one’s for you.

Margaret and I sat down to speak on a topic we rarely hear spoken plainly: suicide, and more specifically, suicide risk assessments. We didn’t plan to tidy anything up or wrap it in easy language. Instead, we tried to sit with it—the fear, the responsibility, the human ache behind it all. We talk about how suicide shows up in our clinical work, how it’s shaped us personally, and why we both believe silence helps no one. This isn’t a “how-to” or a lecture. It’s a real conversation between two people trying to hold space for pain, and maybe offer a little hope in the process.

This episode felt like a deep exhale. Margaret runs solo today, as she sat down with Dr. Hillary McBride—psychologist, author, and researcher—to talk about embodiment, trauma, and the radical act of tuning back into ourselves.We talked about what it means to feel your feelings in your body, why disconnection often begins as protection, and how pleasure, presence, and play can be part of the healing process. It’s about more than coping. It’s about coming home.This one surprised me, and stayed with me. I think it might do the same for you.

This is the episode I wish we never had to make—and also the one I wish I’d had from the beginning. Margaret and I talk about suicide from inside the profession: what it’s like to lose a patient, how we carry that grief (or numbness), and why the aftermath is rarely as clear-cut as people think.We talk about the fear of getting it “wrong,” the complicated relief that can come when a patient is finally at peace, and the moments when you realize you’re not the only one who saw it coming. And maybe the most important part? We talk about how hard it is to talk at all.This one’s raw. And necessary. And still full of tenderness.

It’s Part 2 of our deep dive into eating disorders—and this time, we’re going even deeper. We kick off by unpacking our mock therapy session with Dr. Helen Liljenwall, which unexpectedly hit close to home for all of us. Then we take a sharp turn into the medical realities of starvation, including refeeding syndrome, the female athlete triad, and why your heart is always in the equation (literally).But what happens when patients refuse to eat—and we have to decide whether they need a psychiatric hold? Who gets to say when a person with an eating disorder has lost capacity? And is “terminal anorexia” a compassionate truth—or a dangerous excuse?If you’ve ever wondered what it really takes to treat eating disorders, this is the episode to hear. It's raw, real, and it doesn’t flinch.

This is Part 1 of our two-part deep dive into eating disorders—and we’re starting at the beginning. Margaret and I sit down with psychiatrist and eating disorder specialist Helen Sanon, MD to walk through the basics: What are the major types of eating disorders? What do they actually look like in real life? And how do we treat something that’s rooted in both biology and culture? We cover everything med school skipped—then try to practice what we’ve learned in a fake (but emotionally real) therapy session with Dr. Helen as the patient. Spoiler: it got uncomfortable in all the right ways.

This episode hit harder than I expected. Margaret and I talk about what it feels like to care for patients who remind us a little too much of ourselves, especially when we’re also the ones filling out the paperwork for a psychiatric hold. We dig into what a 5150 (or 5585) really means, how to sit with that kind of authority, and the emotional mess of seeing a patient’s fear reflect your own. This one’s about boundaries, over-identification, supervision, and the heartbreak of sometimes needing to say, “I care about you and I can’t be your doctor anymore.”

In this episode, Margaret and I take on burnout—what it actually is, where the term came from, and how to tell when you’re not just tired, but something deeper is cracking. We dig into the history, the Maslach Inventory, moral injury, and why burnout isn’t in the DSM (yet). We also share our own unhinged burnout moments (yes, mine involves harmonica) and explore how to tell the difference between burnout, depression, and just being in the wrong place.

This might be our nerdiest episode yet—and that’s saying something. In our Season 2 kickoff, Margaret and I sit down with Dr. Margo Funk, psychiatrist and QTC whisperer, to explore the strange, stressful overlap between psychiatry and cardiology. We talk about our worst fears on call, how to spot when an EKG is lying to you, and why it might be time to stop blaming Haldol and start looking at your T wave. There are metaphors involving horses, guns, Timberlake, and Kool-Aid. Somehow, it all makes sense. If you’ve ever been scared of EKGs, risk calculators, or calling your attending at 2AM—this one’s for you.