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The Harvard comment was brilliant. He acted a narcissistic response a little too realistically LOL

This was soooo good!

I would like to _EXCERCISE_ my right to request more Jonathan Shedler~!~!~!~!🤣🤣 (although these guys were great, don't get me wrong!). I'll bet shedler works out...

I appreciate how direct he is and how applicable these resources are! I generally work with OCD from an ACT pov but these skills and resources seem extremely helpful and great to incorporate.

Thoughts Part II: For any neuopsychological correlations to psychotic disorders that you were querying at one point of this interview, I might suggest Mark Solm (if you can get him). Also, when you were talking about antipsychotic medications and schizophrenia, I wonder if you will eventually do an episode on the new med "Cobenfy" (xanomeline and trospium chloride)? Finally, on clozapine, I remember at the tertiary psych hospital I worked at when Covid hit, our patients really suffered (more than usual) due to the risk of Agranulocytosis associated with Covid, and the resulting requirement for more frequent blood draws for monitoring. Carl Jung quote: “A great psychologist is one who must spend his life in a mental hospital. The question is, as a doctor, or as a patient…” th-cam.com/video/sWWtPx2WckU/w-d-xo.html The veil between sanity and insanity is thinner than most people want to admit. Dr. Knafo points out that we all go "insane" every night when we go to sleep and dream, as dreaming is definitely a detachment from reality (e.g., imagining you can fly). Or a young child will create an imaginary friend to fulfill a social deficit that isn't being met. Or love, you often hear the term "crazy in love" or "madly in love", alluding to the power that love has to make one feel "insane". To end, I'll just leave these little links here in relation to the parts of this conversation about connecting with patients with as little power imbalance as possible (i.e., equalizing the relationship, collaborative approaches, etc.) Frank Ostaseski - Gives a beautiful analogy of “coming along side” in our work with people, be it end of life, or therapy th-cam.com/video/V0dbEvMY2V4/w-d-xo.html Frank Ostaseski - Talks about the differences between helping, fixing, and serving. th-cam.com/video/V0dbEvMY2V4/w-d-xo.html

Horray for another psychoanalyst! I could tell he was going to be good as soon as I noticed what appears to be a scroll in the background of Lao-tzu. DP, you really should try to get Dr. Danielle Knafo on to talk on this subject of psychosis. She's very good. More feedback/comments to come, but gotta run for now! (have to tend to my Shedler-shrine 😂)

I like how he paused on that step of recognition and the why for it. I think it's subtle and hard to miss. It reminds me of ernesto spinellis work on sedimentation, just drawing awareness or recognition to a sedimented structure or belief and lingering there can be insightful.

I love Nancy Mcwilliams work she is amazing, It's interesting trying to make sense of Jaak Panksepps work on affective models, i feel like Lisa Feldman and others have debunked some of his work on traditional affective states.

I love your podcast! I have been learning so much, every talk sounds like a class, but a class that I would not want to leave… Nancy McWilliams some of what I would love to become… Amazing work!

¡Gracias!

Also, I forgot Dr Puder is the BEST also...

Ok, im not a MD or DO. Ive become an addict of this podcast. I am a Borderline w Sud, go figure... I have learned soo much just listening to every episode or whatever. I never miss an episode with DR Cummings, he's the best...

damm this guys good...had to watch it again (definitely not the last time). You can tell he's an expert in treating OC traits + tendencies (Not disorders, cause people have _experiences_ , not disorders! 🤣). I could be wrong, but him having his patients write out or record their worst obsessions I believe is referred to clinically, and in the literature, as a *"worry script"* or a *"doubt script"* , essentially desensitizing them to (and having them ultimately face) their worst fear. I remember doing this with a client who had a specific compulsion to not go into certain areas of our hospital where there were windows out of fear a particular type of vehicle was outside watching him and waiting to get him. Loved how he alluded to the psychodynamic concepts of "ego-alien" (aka ego-dystonic), and its opposite, "ego-syntonic". If I remember correctly, disorders like Substance Use Disorder (SUD) and Obsessive Compulsive Disorder (OCD) are ones in which the patient typically views them as being ego-dystonic. You might hear them say something like "I know I shouldn't be drinking 15 beers every night", or, "I know I shouldn't have to turn off the light switches 30 times every time I leave a room, THIS ISN'T ME!" Opposed to disorders like eating disorders (e.g., Anorexia) and Personality Disorders (PD), where they are typically more ego-syntonic, meaning the individual views them as being congruent with, and a inline with who they view themselves to be. You might hear such a patient say "This is who I am! Why are you trying to change me?!" I dont know about you, but for liability reasons, I know I would be worrying if I instructed a patient to sit with his girlfriend with a knife when he had reported thoughts of wanting to murder her (maybe I would be the one having to face this _worry_ , rather than my patient 🤣) 53:51 - Other ones are: "the only thing certain in life, is uncertainty", or "the only thing constant in life, is inconsistency", or "the only thing predictable in life, is unpredictability" 59:04 - Another quote comes to mind here "A man who fears suffering, is already suffering from what he fears"... Finally, his whole approach of facing that which we fear in order to surmount and overcome it (which I whole-heartedly agree with), reminds me of 3 stories that help illustrate this idea: 1. Frank Ostaseski tells a beautiful story that a guy told during a Q & A after a lecture he gave about telephone poles, and how it is analogous to healing occuring when we go towards (and face) difficult emotions, rather than running away from them. Can be seen here: th-cam.com/video/4lHrWO5bvwc/w-d-xo.html 2. The Bison metaphor. The American Bison/Buffalo is a remarkable animal. It does 2 things that other animals don’t do when a cold winter storm is approaching. First, they turn directly towards the storm and position their body right towards it. They do this somewhat counter-intuitively and paradoxically, as they have the most, thickest fur on their head and chest, which allows them to stay the warmest. But then they do something even more remarkable, in an evolutionary adaptive way, they instinctively head right into the storm to avoid suffering the outskirts of the storm where the coldest freezing rain is. They intuitively know “the only way to it, is through it”. 3. Dr. Marvin Goldfried - Tells a story about going on a trip with the esteemed Dr. George Stricker to Iguazu Falls in Argentina (one of the 7 wonders of the world), and going over suspension bridges, and how he helped George overcome his fear of heights by facing them through "repeated trials" together. Great story which can be seen here: th-cam.com/video/qmQ2oi66Ok0/w-d-xo.html

First and foremost is this a GIRL. This is such a well known experiment that any professional should know that. Furthermore It might surprise you but not every living being on the planet is male. Then the infant expresses frustration, not anger.

This approach to confronting the compulsions head on (and in many cases ratcheting them up in intensity as he alluded to, to the point where the client eventually agrees full-heartedly with the intrusive thought) really makes sense. It reminds me of the phrase "the only way to it, is through it"....what he's really talking about here is a type of exposure therapy, albeit, exposure to one's own intrusive thoughts. Also reminds me of the phrase "avoid avoiding". Finally, all this talk of OCD brings back pleasant, nostalgic, memories of watching the first video I ever watched of the Shedster (the one you had him on to talk about OCD). As if I need to say it, but please more Shedler the great!!~!~!~!!!!🤣🤣

I appreciate this I truly love ACT and Psychodynamic theory. Mixing the two i think dissolves the behavior preceding thought vs thought preceding behavior and takes the best of both and is able to look to see which piece is helpful to the client at specific moments.

Omg, thank you so much for this discussion! You don't know how long I've been waiting for this episode on OCD! Thank you, dr. David!

Thank you for this. Helped me write my paper on CPT

dat role play.....so gud...

thank you!

Denial

Why do people pronounce "personality disorder" like personalty ssorter?

I hate being retired and not being able to put this knowledge into practice.

Do yourself a favor speed up playback

In the realm of the mind's intricate dance, Where thoughts intertwine and emotions advance, Stands a figure of wisdom, a guiding light, Dr. Jonathan Shedler, a scholar's delight. Born with a thirst for knowledge, a keen mind, He traversed the paths of the psyche to find The secrets that lie within the human soul, Unraveling the mysteries, making them whole. With a passion for understanding the self, He delved into the depths, like a curious elf, Exploring the realms of the unconscious mind, Revealing the truths that others had not defined. His work, a tapestry of insight and care, Weaving together the threads of despair, Guiding patients through the labyrinth of the mind, Helping them find the peace they so longed to find. From the halls of academia to the clinic's door, Dr. Shedler's influence has touched evermore, His theories and techniques, a beacon of hope, Empowering individuals to better cope. With a keen eye for detail and a heart of gold, He listens, observes, and the story unfolds, Unraveling the complexities of the human psyche, Offering solutions that are both practical and unique. His work on the "Shedler-Westen Assessment Procedure," A groundbreaking tool, a diagnostic treasure, Revolutionized the way we understand and treat The intricate patterns of the mind's retreat. Through his research and clinical expertise, He has shed light on the mysteries that never cease, Helping us navigate the labyrinth of the self, Guiding us towards a healthier, more balanced wealth. In the realm of psychotherapy, he stands tall, A beacon of hope, a mentor to us all, Inspiring generations of clinicians to come, To delve deeper, to learn, and to overcome. His writings, a tapestry of wisdom and grace, Weaving together the threads of the human race, Offering insights that challenge and inspire, Igniting the flame of the therapeutic fire. From the depths of the unconscious to the conscious mind, Dr. Shedler's work has left an indelible grind, Shaping the way we understand and approach The complexities of the human psyche's approach. In the annals of psychology, his name will be etched, A testament to the brilliance he has hatched, A visionary, a scholar, a healer of the mind, Dr. Jonathan Shedler, a true pioneer of his kind. As we bask in the glow of his remarkable deeds, We are reminded of the power of the mind that exceeds, The boundaries of the known, the limits of the past, For with Dr. Shedler's guidance, we can truly amass. The knowledge and understanding that we seek, To navigate the complexities of the human mystique, For in his work, we find the keys to unlock The doors that lead us to a healthier, more balanced stock. So let us raise a glass to this esteemed scholar, Whose contributions have made the world a little taller, A beacon of hope, a guiding light in the dark, Dr. Jonathan Shedler, a true master of his mark.

This video actually allows someone to mentalize a narcissist beyond just them being self centered. A lot of the problems seem to come from a fear of rejection and fear of loss that causes them to obsess over themselves because they are worried about what others think. Kind of ironic that someone who comes off as self-centered is actually overly concerned with others perceptions. So what you see is their lack of empathy but what you don’t see is their longing to connect. so much more to say but that’s just some of my thoughts coming from someone who could definitely be diagnosed antisocial/narcissistic/BPD. Also greetings from Orlando :)

I'm just over half way through and I just have to say thank you, Dr. Puder, for your consistent willingness and desire to engage in roleplays in so many of your psychotherapeutically focused episodes. It seriously enlivens the theoretical material and provides a very special opportunity for us viewers to witness the application of theory by some of its most esteemed practitioners and, in this case, progenitors. Truly awesome. Thanks again to you and your guests. Inspiring work.

I love the role plays. They are my favorite part of watching these as a layperson

Interesting stuff. I did groups with inmates serving long sentences and found it so difficult to focus them; the default was always, the system or the corrections officers made it impossible for them to make any progress in any sense. They were "screwed" and that was that.

It’s good you draw a distinction between pathological and the normalised narcissism of everyday life. At many work envts, if not required, often expected and frequently interpreted as motivation, antagonistic spirit etc. The average person is not psychologically literate enough to prevent it from becoming pathological. Thanks for bringing this conversation online. As always, informative in many ways.

Great podcast! More please.

I’m working with a client with anti social traits currently, and it feels like my usual training is out the window. Lots of lying and the here and now feels inaccessible. Any progress made one session feels disowned the next week

As a teacher I really relate to the discussion on presenteeism and the burden of taking time off to take care of our own needs. Great episode, I listen because if I could go back I would/should have been a therapist. I’m passionate about mental health and love learning about it.

« nurse practionner who works for me .... » 🥲 could've been «with me »... but ok.

Thank you for this episode!I am really happy that you spoke about writing as a therapeutic technique !I am a huge proponent of it especially hand writing when anxious or depressed or burnt out!

First. Another great episode DP! (Dr. Puder). Loved the much needed conversation surrounding the stigma of healthcare professionals asking for help and taking time off. As a care provider who recently got my licensure, let me help further de-pathologize this topic by sharing that I have zero shame in calling my local crisis-line when I find I don't have anybody to talk to and am experiencing extreme periods of intense stress (have been doing it for years! 🤣😅). 7:22 - What she describes here reminds me of the term " _Moral_ _Masochism_ " whereby we view ourselves as more virtuous and valuable the more we suffer (also tied to conditions of self-worth - e.g., "I'm only worthy if I suffer") . Shedler describes this more here th-cam.com/video/An52UobuQ8w/w-d-xo.html 31:30 - This reminds me of Dr. Danielle Knafo recounting a quote from Carl Jung where he once said " _A_ _great_ _psychologist_ _is_ _one_ _who_ _must_ _spend_ _his_ _life_ _in_ _a_ _mental_ _hospital_ . _The_ _question_ _is_ , _as_ _a_ _doctor_ , _or_ _as_ _a_ _patient_ ...." 🤣 She describes this here: th-cam.com/video/sWWtPx2WckU/w-d-xo.html

thank you for bounding hopefulness at 45:20 - it deeply annoys me when this narrative becomes one of healing and empowerment - the responsibility of the patient - when the narrative needs to move past just an out-of-touch resilience narrative to something that is individually helpful to the patient.

This is the best psychopharmacology episode i have heard so far

This experiment has long lasting in the child's HPA axis. Repair is most important for the child, if the experiment is deemed necessary for the dad's education, as it could lead to broken trust and a life time of emotional avoidance.

Highly recommend letting your guest speak when you ask a question. Constantly talking over her is such a misogynistic approach to the interview.. She never has an opportunity to finish a thought before you've taking over.

This brought Deep long forgotten memories 🙏🏻🥲

I hope the other specialists who speak on the same topic forgive me , but it is such a different level of narrative when an actual psychiatrist who works at university or in hospital discuss mental problems . May we have more speakers like that !

Despite the serious lack of Shedster, this really was a tremendous, great, and informative video! 😋 7:11 - When Dr. Bender is talking about constancy of self, it reminded of Dr. McWilliams talking about this as being one of her "10 domains of psychological health" (Self-continuity - Stable, constant sense of self throughout the lifespan. Also tied to relationship with one’s body (e.g, viewing it as self, or foreign) She describes more of this here th-cam.com/video/Tv6yNJcZhl0/w-d-xo.html 8:33 - When Rachel talks about "early developmental tasks", it reminds me of Erickson's psychosocial stage of "Industry VS Inferiority", whereby the child either gains an internal sense of being able to effect the world (agency) and become good at something, _or_ _not_ . Also reminds me of Joseph Weiss's Control/Mastery theory (even though I know this describes somewhat of a different process). 14:35 - When Dr. Bender talks about patients who come in saying "I just got to get *IT* (the unpleasant memories) out of me". This would be an example of Freud's I/It distinction, whereby we disavow things which are unpleasant to the self (IT), and claim ownership of positive things we feel as belonging to us (I). 18:30 - love the beach-ball and Voldermort analogies to not dealing with/naming one's emotions. Reminds me of Daniel Siegel's "name it to tame it, feel it to heal it". 20:56 - Very astute point by Dr. Bender about the isomorphic, parallel processes in regards to his experience watching the character of "anxiety" in the movie, and how it actually feels in real life. 😅 Finally, I wonder what type of personality "type" or "style" Riley would be (e.g., hysterical, schizoid, obsessional, counter-dependent)? Moreover, what level of personality organization she would be (e.g., Neurotic, Borderline, Psychotic)? p.s...any idea when our little cohort is starting?? (the one for "advancing psychotherapy skills and connecting with a community of like-minded mental health professionals").🙂

I wish we could hear what Dr. Puder was about to say! I was really interested! (thank you Dr. Puder to mention that we don't want to negate the experience of someone who experienced abuse by someone with NPD)

I’m curious if anyone here has family members who have a borderline dx?

I'm a med student, really enjoyed it, thanks, keep making these podcasts

Very helpful, thanks everyone

I am 51, (GAD) had first major panic attack at 19. Anxiety sent me home from school away and kept me out of joining the Army. married in 2005 had a 2009 baby and a 2012 baby. now for my two pregnancies in my late 30’s my doctor allowed Prozac and Trazodone only but sometime maybe after 8 weeks of breast feeding I am assuming I have been on Cymbalta. There have been times in my life when I have been able to not need it (but the exercise regiment was dedicated) but for the most part Cymbalta has been the miracle drug. Of course .. there is one bummer side effect I imagine most married patients have and the biggest temptation to come off it at times. The med that works as well as Cymbalta and doesn’t have that side effect would be as good as gold. I have been on 60mg for most of this time. I have been increased to 120 to get through time that include worrisome life times. Small panic attack for no real reason brought me to this video .. this happens every time I attempt a break from the drug .. I have probably skipped a couple days .. You discuss perimenopause.. and oh yeah this med is a keeper ..

I am 51, (GAD) had first major panic attack at 19. Anxiety sent me home from school away and kept me out of joining the Army. married in 2005 had a 2009 baby and a 2012 baby. now for my two pregnancies in my late 30’s my doctor allowed Prozac and Trazodone only but sometime maybe after 8 weeks of breast feeding I am assuming I have been on Cymbalta. There have been times in my life when I have been able to not need it (but the exercise regiment was dedicated) but for the most part Cymbalta has been the miracle drug. Of course .. there is one bummer side effect I imagine most married patients have and the biggest temptation to come off it at times. The med that works as well as Cymbalta and doesn’t have that side effect would be as good as gold. I have been on 60mg for most of this time. I have been increased to 120 to get through time that include worrisome life times. Small panic attack for no real reason brought me to this video .. this happens every time I attempt a break from the drug .. I have probably skipped a couple days ..

This episode genuinely answered so many of my questions I’ve had about the treatment modalities used with BPD. The information on benzodiazepines effect on BPD was so helpful and informative as well. 👏🏻