Best Clinical Thinker Podcasts (2024)

1
In a Word - Transference (with a dash of neuroscience) 30:10

6d ago30:10

30:10

Send us a Text Message. Dr. O'Leary discusses the term Transference, and if you listen until the end, he relates it to some computational neuroscience. Transference is a historically loaded term. Transference is supposed to be an unconscious process, so it can not really be observed, only inferred, so this means that both the definition of transfer…

1
Catatonia in Autism and Neuroatypical Patients - Easy to miss, Harder to Treat 35:54

7d ago35:54

35:54

Send us a Text Message. -- More recently I have faced the diagnostic conundrum of catatonia in autism, and that is what I want to explore in more excruciating detail today. There is surprisingly little literature on the subject, and that is concerning because being able to identify and treat catatonia can be life-saving, not to mention life-alterin…

1
Mindhunting with Forensic Psychiatrist Dr Michael Schirripa 56:11

22d ago56:11

56:11

Send us a Text Message. -- Dr. O’Leary interviews forensic psychiatrist and author Dr. Michael Schirripa about his career as a forensic psychiatrist, the release of his first thriller, Mindhunt, and his podcast Mindhunting. Dr. Shirripa explores how his love of literature influenced his decision to pursue forensic psychiatry and ultimately resulted…

1
Psychedelics - A skeptical approach to MDMA aka Ecstasy 31:46

1M ago31:46

31:46

Send us a Text Message. - - In the world of psychotropic medication, the question is not just whether it works or not, but whether it works better than a placebo and whether the effect size is clinically significant and the benefits outweigh the risks. In the case of MDMA (aka molly or ecstasy), the effect size for improving post-traumatic stress d…

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The Narrative Fallacy in Psychological and Psychiatric Clinical Practice with Dr. Alexey Tolchinsky, PsyD 55:14

2M ago55:14

55:14

Send us a Text Message. The Narrative Fallacy describes our tendency to find meaning, connections, and causal relationships where they do not necessarily exist. In this episode, Dr. O'Leary had the pleasure of interviewing Dr. Alexey Tolchinsky. He recently published a paper called “Narrative fallacy and other limitations of psychodynamic case form…

1
Psychometrics - The Dangers of Rating Scales and Screeners 31:45

2M ago31:45

31:45

Send us a Text Message. Dr. O'Leary discusses a variety of concerns that all clinicians should have in mind when using psychometrics. In the end, he hopes you come away with some level of agreement with the statement: “Our primary concern should not be with the quantity of data, but with the quality of the data.” Statistics are conceptual machines …

1
In a Word - Aphasia 37:22

2M ago37:22

37:22

Send us a Text Message. In this episode, Dr. O'Leary discusses a word that he has struggled to understand since medical school. The word is aphasia. The root “phasia” comes from the Greek phanai which means “to speak.” When aphasia is used medically, it refers to an inability to speak, although not always. More generally it is often used to mean a …

1
WTF Cerebellum - Little Brain, Big Deal 32:58

3M ago32:58

32:58

Send us a Text Message. I did not until recently even consider the cerebellum when thinking about psychiatric conditions, but the more I read, the more I wonder why the cerebellum is not considered a potential important player in nearly every psychiatric disorder. Although it can be said that all brain regions primarily function to make predictions…

1
WTF - Thalamus 22:32

4M ago22:32

22:32

Send us a Text Message. The thalami are bilaterally symmetrical structures in the subcortical part of the brain that are cradled by the basal ganglia. They are major hubs of pretty much everything your brain does and all of the sensory information coming into the brain with the exception of smell. More primitive models of the brain visualized it as…

1
Seroquel (Quetiapine) - Drugs, Sex, Money and Psychopharm 24:53

4M ago24:53

24:53

Send us a Text Message. In this episode, I discuss a medication that patients who saw a psychiatrist or their primary care provider between about 1997 and 2015 were very likely to find themselves prescribed. More recently, it has been taken down a notch or two on prescribers lists of preferred meds. This medication is quetiapine, marketed as Seroqu…

1
In a Word - Confabulation 14:22

5M ago14:22

14:22

Send us a Text Message. This episode continues an intermittent series called “In a Word.” Past episodes have explored words like Akathisia, Dissociation, Perseveration, and even the difference between Impulsive and Compulsive. This episode explores Confabulation, including some of the brain circuits involved, and what might differentiate confabulat…

1
How guilty are adolescents for their crimes? 29:31

6M ago29:31

29:31

Send us a Text Message. In 2012 the Supreme Court heard two related cases involving adolescents convicted of murder and sentenced to life in prison without parole because of mandatory minimum sentencing guidelines in their states. One of the boys, Evan Miller along with an accomplice, had beat a man unconscious with a baseball bat after a fight tha…

1
Serious Mental Illness in America with Dr. Zac Brooks 45:59

7M ago45:59

45:59

Send us a Text Message. I am lucky today to be able to bring you an interview with Dr. Zac Brooks who is passionate about serious mental illness (SMI). “What is serious mental illness?” you might ask. That is one of the things we are going to discuss, and you may be surprised when Dr. Brooks explains how it was first formally defined. We also discu…

1
HIV, PrEP, and Mental Health with Dr. Jon Lindefjeld 46:48

7M ago46:48

46:48

Send us a Text Message. PsyDactic welcomes Dr. Jon Lindefjeld for a discussion of the history of HIV and AIDS. In particular, we discuss the development of effective antiretroviral therapies, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP), highlighting the CDC guidelines for use and monitoring, need to treat psychiatr…

1
Perspectives on the Borderline: The Most Disordered Personality 40:07

7M ago40:07

40:07

Send us a Text Message. Dr. O'Leary discusses some of the history of the borderline personality, how different perspectives have attempted to explain its origin, how to treat it and how not to treat it. He starts in 1947 with some colorful descriptions of patients living with borderline personality disorder that would never get published today, and…

1
The Ghost of Personality Disorders Future 23:27

7M ago23:27

23:27

Send us a Text Message. Our current diagnostic criteria for personality disorders have failed to demonstrate validity or reliability. The DSM 5 encouraged psychiatrists to start considering a broad range of personality features adapted from the Five Factor Model. These are combined with global functioning measures to build a personality inventory f…

1
Tattoos, Stigma, Racists, and Psychiatry 26:11

7M ago26:11

26:11

Send us a Text Message. Humans have a history of tattooing that stretches millennia into prehistory. The western ban on tattoos by the early church resulted in a systematic effort to paint tattooed individuals as pagan, primitive, vulgar, criminal, and mentally ill. Psychiatrists have historically contributed to this characterization but are in a p…

1
Attractor Networks and the Bayesian Brain 58:06

8M ago58:06

58:06

Send us a Text Message. The brain understands the world by building models that predict the future. One of the ways that it does this is by utilizing attractor networks. These small world networks are constantly trying to determine what is a true signal from the constant noise in the neural net. Dr. O'Leary explores how attractor networks have been…

1
Serotonin - Jack of All Trades, Master of None 32:44

8M ago32:44

32:44

Send us a Text Message. When I started to make this episode, I thought I would try to do a comprehensive review of all of the various functions of serotonin across its 15 or more receptor types, but I soon found myself overwhelmed. More importantly, I found that some stories are more interesting to tell than others, so here I discuss serotonin and …

1
Antipsychotics and their discontents 21:31

9M ago21:31

21:31

Send us a Text Message. Frequently I have complained that the terms "typical and atypical" or "first generation and second generation" antipsychotics were not very helpful. When I give chalk talks to junior residents and interns about antipsychotics, this is one of the first things that I note. It is the medicines relative affinities for different …

1
Extrapyramidal Side Effects and Tardive Dyskinesia for Super Nerds 37:22

9M ago37:22

37:22

Send us a Text Message. This episode explores side effects of antipsychotics at the molecular level. It starts by exploring receptors and their ligands and takes a turn into the dorsal striatum where dopamine, acetylcholine, serotonin, and glutamate work together to help us dance the mamba. Dr. O'Leary explores what happens when the complex pathway…

1
The STAR*D Trial: Scientifically Flawed or Scientific Fraud? 22:02

9M ago22:02

22:02

Send us a Text Message. The authors of the famous sequenced treatment alternatives to relieve depression trial or STAR*D reported that about two-thirds or 67% of patients had achieved remission after 4 trials of antidepressant medication. This remission rate has been questioned over the years and in October of 2023, the journal BMJ Open published a…

1
Dopamine Networks and Psychosis 32:17

9M ago32:17

32:17

Send us a Text Message. This episode is about dopamine. In episode 32, I discussed the pseudoscientific trend of the “dopamine detox” or "dopamine fasting." Instead of talking about pseudoscience in this episode, I discuss the actual science surrounding dopamine and its relationship with the neuroleptics or antipsychotics as they are more commonly …

1
In a Word - Impulsive vs Compulsive 29:00

10M ago29:00

29:00

Send us a Text Message. In this Episode, I continue an intermittent series called “In A Word.” The difference between prior episodes and this one is that today I have two words. I chose these words because I don’t really know the difference between them, and even after reading and trying to understand the difference, I am not sure that there is a c…

1
Interview Season Is Upon Us 40:14

10M ago40:14

40:14

Welcome back to R&T IMG Clinicals podcast. Appearing in our podcast is the Founder and Director of USMLE Sarthi (United States Medical Licensing Examination), Pawan Khera. Now that match season is under way, Pawan sat down with me to discuss a few important topics. Pawan also addresses the question of the Personal Statement, contacting a program, t…

1
Traumatic Brain Injury - How Severe Was It? 24:34

11M ago24:34

24:34

Send us a Text Message. I discuss something that is likely to present itself to a physician long after the fact: a single mild brain injury. This episode focuses on how to classify the severity of a single brain injury. While working in a brain injury unit, I noticed that some providers used the term severe brain injury when referring patients to n…

1
So, You've Completed an Internal Medicine Rotation. What Did You Learn? 38:24

11M ago38:24

38:24

On today's podcast, we are joined by Dr. House himself, World Famous Internist, Dr. Cedric L. Coleman, MD. Mr. 'WYD' (What’s Your Data) Dr. Coleman is a Board Certified Internist and Associate Professor of Medicine at Rush University, Department of Internal Medicine. Dr. Coleman is one of the most requested Internists with one of the highest matchi…

1
The Medial Prefrontal Cortex 15:28

1y ago15:28

15:28

Send us a Text Message. This episode continues a series on the prefrontal cortex, a complex region of the brain that gives us the ability to have the kinds of thoughts no other species on earth is known to have. The medial (or mesial) prefrontal cortex is especially important for emotional and autonomic regulation, attention and goal-directed behav…

1
The Orbitofrontal Cortex - Our built-in Economist 25:30

1y ago25:30

25:30

Send us a Text Message. In this episode, I am sliding down and under the front part of the brain and consider the orbital frontal cortex, that part of the brain right above and a little behind your eyes. It is much smaller than the lateral gyri on the prefrontal cortex, but appears to be an important probability generator in our brain when we need …

1
The Dorsolateral Prefrontal Cortex - Our Executor and Speech Writer 36:15

1y ago36:15

36:15

Send us a Text Message. We seem to understand the specializations of the the dorsolateral prefrontal cortex on the left better than the right side of our brain. That is because most of us do a lot more language processing on the left or dominant side. The more inferior and caudal parts of the dorsolateral PFC on the left side are more specialized f…

1
The Prefrontal Cortex - An Introduction to What Makes Us Human 20:09

1y ago20:09

20:09

Send us a Text Message. Besides being relatively hairless apes, there are some things about humans that make us special among animals. In the past we have noted things like, “We have big brains and we use tools,” or “We contemplate the future and our own mortality,” or “We use a truly complex language both verbal and written to communicate complex …

1
Psychological versus Neuropsychological Testing 40:23

1y ago40:23

40:23

Send us a Text Message. This episode is about how to decide whether to send a patient to get neuropsychological or just psychological testing, and this decision is determined by at least two things. The first is the question that you are trying to answer. The second is, what can the service that I am referring to provide for the patient? In this ep…

1
Retention. Regression 11:57

1y ago11:57

11:57

Landria talks about her perspective concerning holding kids back in school. A discussion about regression and retention and why we should take these words off the table when it comes to educating children.By LandriaSealsGreen

1
In a Word - Validity 25:50

1y ago25:50

25:50

Send us a Text Message. Today I discuss the term “validity.” Let’s say we wanted to develop a test that identifies pathological character traits or quantifies depression symptom burden on a patient. A good test is going to do more than simply list the diagnostic criteria for various diagnoses and then ask the patient if they think that sounds like …

1
Guns - Starting the Conversation 29:41

1y ago29:41

29:41

Send us a Text Message. Today I talk about guns. More specifically, I talk about talking about guns. Please leave feedback at https://www.psydactic.com. References and readings (when available) are posted at the end of each episode transcript, located at psydactic.buzzsprout.com. All opinions expressed in this podcast are exclusively those of the p…

1
In a Word - Akathisia 23:17

1+ y ago23:17

23:17

Send us a Text Message. Today I am continuing an intermittent series called, “In a Word,” and the word that I chose for today is akathisia. Akathisia is broadly defined as an inability to remain still. If you ask someone with Akathisia to stop moving, they will likely become very uncomfortable, but while they are moving, they experience at least so…

1
Dopamine Detox and Pseudoscience 29:00

1+ y ago29:00

29:00

Send us a Text Message. There is a narrative wave in popular psychology and neuroscience that has taken a small amount of very basic science and twisted it into a fantastic narrative of feast and famine. Its central character is dopamine. The Dopamine Detox also known as dopamine fasting is a pseudoscientific treatment that at best illustrates how …

1
Webuiltaschool.spep2.huddle5 6:44

1+ y ago6:44

6:44

In this episode, Landria gives insight into her self-talk and why of being a school for kids who are neurodiverse. #excelprepschools #autism #learningdisabilities #education #specialeducation #innovationBy LandriaSealsGreen

1
Webuiltaschool.spep1.huddle5 8:14

1+ y ago8:14

8:14

In this episode, Landria talks selection of curriculum and tools to teach students with specialized learning needs. How do we select? How some tools don't make sense and how are we really looking at skill and meeting the needs of children? She introduces the concept of #ExcelPrepSchools.By LandriaSealsGreen

1
Artificial Intelligence and Psychiatry 26:45

1+ y ago26:45

26:45

Send us a Text Message. I have recently added some artificial intelligence produced answers to psychiatry questions in my past episodes in an effort to try to understand what it is that AI text generators can do and what value they might add to my future as a psychiatrist versus what problems it might introduce into my practice. I realized that sin…

1
What is a placebo? 24:31

1+ y ago24:31

24:31

Send us a Text Message. What is a placebo? You may already be thinking something like: A placebo is an imitation, fake, sham, decoy, or trick treatment that we give to people in studies to see if the treatment under investigation is any better or worse. Placebos are supposed to be both benign and inert, meaning they should neither harm nor help a p…

1
In a Word - Dissociation 25:42

1+ y ago25:42

25:42

Send us a Text Message. This episode is the second in an intermittent series I am calling In A Word. Psychiatry is full of terms that are either poorly defined or used in such broad ways that they are not very helpful by themselves. Trying to come to terms with terms we throw around can help us to understand the conditions we treat better, and hope…

1
Adult ADHD and Bayesian Reasoning 21:56

1+ y ago21:56

21:56

Send us a Text Message. Bayesian reasoning is likely operating in your mind whether you realize it or not, whether you can do the math or not. In this episode, Dr. O'Leary explores how to explicitly use Bayesian reasoning to put actual numbers to our inherent biases. Attention Deficit Hyperactivity Disorder (ADHD) seems like a good place to start. …

1
Artificial Challenges for Physician Mental Health 14:23

1+ y ago14:23

14:23

Send us a Text Message. Society is in upheaval in the way that it discusses mental health. There are many loud voices out there. Some of these advocate for more openness and less stigma with regard to how we treat people with behavioral and psychological disorders, and by "treat," I don’t mean with drugs or therapy, but with our words, actions, pol…

1
Neuropsychiatry - Huntington Disease 30:02

1+ y ago30:02

30:02

Send us a Text Message. Dr. O'Leary reviews one of the most frustrating diseases that a patient and their family might approach a psychiatrist with: Huntington’s Disease. Huntington’s Disease is a neurodegenerative disorder, which means that over the course of the disease neurons die or cease to function correctly and this worsens over time. The de…

1
Neuronal Networks: Depression 29:12

2y ago29:12

29:12

Send us a Text Message. It is unlikely that any model of major depressive disorder is likely to find universal signals among those diagnosed because the symptoms are so diverse. However, it does seem likely that models, such as brain-network models, will be able to identify common dysfunctions among those with similar symptom burdens (for example, …

1
Treating Bipolar Depression with Dr. Tom DePietro 38:39

2y ago38:39

38:39

Send us a Text Message. Bipolar disorder is a complex, often debilitating and potentially life threatening illness in which the patient goes from episodes of depression to episodes of mania or hypomania, most often with periods of relative euthymia in between these episodes. The most common way to conceptualize the treatment of bipolar disorder is …

1
Neuronal Networks: The Central Executive Network... and some philosophy 20:24

2y ago20:24

20:24

Send us a Text Message. In previous episodes I have tried to draw pictures in your mind (using those fat crayons that babies like to chew on) of some of the brain networks that are important in many mental illnesses. We have talked specifically about the Default Mode Network (that is concerned with imaginal thoughts and self-referential thoughts an…

1
Neuronal Networks: The Salience Network 14:16

2y ago14:16

14:16

Send us a Text Message. What is salience? Fundamentally it is a value judgment that determines where your brain will place its limited resources. There are a lot of things that could draw our attention. The world is full of sights, sounds, smells, pressures, temperatures, stretches. Our mind is full of thoughts. Without a salience network, we would…

1
Neuronal Networks: The Attention Networks 12:38

2y ago12:38

12:38

Send us a Text Message. Today, I am going to explore the Attention Networks, which are the parts of our brain that get really excited when, for example, we see something that we have never seen before, something that appears to be moving on its own volition (and might harm us), something that appears out of place (like an eyeball on the floor), or …

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