200 Episodes Later: A Journey Through Psychiatry with Dr. Puder
Manal Piracha
Join us today on the 200th episode of the podcast, as Dr. Puder sits down with Dr. Mark Mullen to discuss the podcast and reflect on some of his favorite episodes. Dr. Mark Mullen is a 4th year psychiatry resident at Creighton University in Omaha, Nebraska, and the host of his own podcast, Psychiatry Bootcamp.
The Psychiatry And Psychotherapy Podcast
Dr. Puder’s motivation for the podcast stems from a passion to teach mental health professionals how to create more meaningful connections with their patients. It has become a great source of meaning for Dr. Puder, as it has exponentially increased his ability to impact mental health professionals and platform many brilliant, but lesser known in scope, minds in the field of psychiatry. He says, “If I can train 10,000 mental health professionals to do their work better than they were doing before, that would create so much meaning for me.”
To this day, Dr. Puder says one of his greatest internal motivators for the podcast continues to be the ability it gives him to share invaluable knowledge from others in his field and extend their impact. The positive feedback from listeners and stories of how people are impacted by the podcast fuels the passion for future episodes.
As he developed the podcast, Dr. Puder was most surprised by the ability to truly interact with the people he interviews. He enjoys being able to interview such incredible and intelligent people that he has looked up to in the field.
The Success Of The Podcast
Some positive feedback Dr. Puder has received about the podcast is that the way complex, relevant topics are presented in such an approachable, conversational manner sets it apart from other related podcasts. It draws people in with its vulnerability and authenticity and the culture of willingness to look beyond the psychiatric criteria and psychopharmacology to holistically assess a condition.
Psychiatry is an art and patients come to be listened to and heard. From the very first encounter with a patient, mental health professionals must show up and be present with the patient in order to foster the most effective relationship. When the clinician is more connected, they truly will see better results with their patients. Psychotherapy is all about connection and, most of the time, more dependent on the provider than the actual modality or treatment plan.
A unique takeaway from the podcast is the encouragement to pick up the small moments of emotions and microexpressions of the patient, which can allow the therapist to embody more compassion for them.
Dr. John Tarr: One Of The Biggest Motivations Behind The Podcast
Dr. John Tarr, who passed away this year at the age of 94, was a renowned psychiatrist and psychoanalyst. His influence on Dr. Puder was incredibly profound, inspiring him to create the podcast in the effort to expand his impact on more medical professionals.
Dr. Puder met Dr. Tarr during his (Dr. Puder’s) first year of residency in psychiatry when he joined his introductory class on therapeutic alliance. Over time, their relationship became one of mentor/student and colleague, even teaching jointly at Loma Linda University for the past nine years. Dr. Puder and Dr. Tarr’s worldviews aligned so precisely that they understood each other very well. This sometimes allowed them to anticipate what the other would say in situations with patients. Their thought processes molded into one because of the extensive amount of time they spent together in psychotherapy training and teaching.
While in Dr. Tarr’s class as a first-year resident, Dr. Puder easily developed an admiration for his brilliance. He had the ability to passionately teach psychotherapy using complex language and thought processes that were challenging, yet incredibly intuitive at the same time. Dr. Tarr was a prolific reader who studied the great works of previous psychiatrists and psychotherapists, retaining the posture of a student throughout his life, never quenching his dedication to learning. Additionally, he was mentored by the legendary psychoanalyst, Franz Alexander.
Dr. Tarr’s belief in the power of knowledge was not consigned to the field of psychiatry— he placed high value on all mediums of learning including the arts, traveling, and the beauty of human diversity. He was a loyal and generous benefactor within the music and art community and traveled the globe with his wife, Beverly. Over his lifetime, he developed relationships with a rich spectrum of people. His openness and ability to save a humanizing space for every individual and idea was a very rare and valuable quality.
When asked to identify the most meaningful lesson he learned from Dr. Tarr, Dr. Puder instead offered the observation that it was not one single piece of information or particular moment of guidance that impacted him the most. Rather, it was the way he ultimately internalized who Dr. Tarr was. We all naturally internalize close, meaningful relationships, and Dr. Puder holds his influence as sacred, expressing what will be lifelong gratitude towards Dr. Tarr. “The kindness with patients and colleagues over time became internalized as a fatherly figure,” said Dr. Puder.
Dr. Tarr’s ability to hold an unconditional positive regard for people was unmatched. He treated his patients with an abundance of empathy and left a meaningful mark on his family and friends. His legacy will produce far-reaching results beyond what he or Dr. Puder did and will singularly do in their lifetimes, as Dr. Tarr's influence multiplies through Dr. Puder’s modern social platforms.
Dr. Tarr was an expert in empathy and truly cared about exploring the patient’s fears and anxieties. He had a worldview that allowed him to have deep and profound kindness and compassion towards his patients. He would make sense of a patient’s internal world by thinking about their attachments, life experiences, and temperament.
Dr. Tarr’s Work With The Pre-Lexical Learning Period
He was passionate about discussing the pre-lexical period, which covered communication before the development of vocabulary or language—a dance of nonverbal communication. Early attachment periods of development, beginning in the first weeks of life, would be considered the prelexical period. Dr. Tarr was incredibly skilled at identifying prelexical content in therapy sessions and communicating the attachment language back to the patient, providing invaluable information for reaching into the patient's feelings and emotions.
Dr. Puder dedicated the therapeutic alliance series to Dr. Tarr:
Episode 028: Therapeutic Alliance Part 1
Episode 032: Therapeutic Alliance Part 2: Meaning and Viktor Frankl’s Logotherapy
Episode 036: Therapeutic Alliance Part 3: How Empathy Works and How to Improve It
Episode 041: Therapeutic Alliance Part 4: What is Transference and Countertransference?
Episode 062: Therapeutic Alliance Part 5: Emotion
Episode 069: Therapeutic Alliance Part 6: Attachment Types and Application
Episode 070: Connecting with the Psychotic Patient, Therapeutic Alliance Part 7
Reflecting On Favorite Episodes
Episode 171: Nancy McWilliams on Mental Health, Transference, and Dissociation: "Listening in a professional capacity is a disciplined, meditative, and emotionally receptive activity in which the therapist's needs for self-expression and self-acknowledgment are subordinated to the psychological needs of the client" (McWilliams, 2004, p. 133).
In this episode she discusses the adaptive nature of dissociation. For example, when a patient experiences a traumatic event, their brain may dissociate as a defensive mechanism to protect the patient from the distress of the trauma.
Transference is common in patients who dissociate because those who have been mistreated in the past are likely to see the therapist as a threat. The patient sees the abuse they experienced in anyone they interact with.
Episode 194: Dr. Sue Johnson: Attunement, Attachment and the Development of Emotionally Focused Therapy: Dr. Puder loved connecting with her and hearing her exuberance regarding attachment. She focused her research on intimate relationships and attachment bonding, emotion, clinical couples therapy, the process of change in psychotherapy and marital therapy, and the role of emotion in therapeutic change
Episode 195: Dr. Robert Sapolsky: Baboons, Stress Research, Connection and Determinism: It was great to interact with him, even though Dr. Puder didn’t necessarily agree with his viewpoint.
What’s Next For The podcast?
Dr. Puder plans to continue interviewing mental health professionals with 20+ years of experience in certain domains that can provide value to the larger community of mental health professionals. (If you are one of those, write here.) He hopes to cover topics that have not received much coverage yet and has a topic series in mind he hopes to begin with guests. He plans to do more episodes with Dr. Cummings and also hopes to release audio clips of Dr. Tarr in order to share his knowledge and perspective with the audience.
If you are a long time listener, please take a moment to introduce yourself to Dr. Puder. You can do that either on social media or through our contact form here.