Understanding Mature Defense Mechanisms in Psychotherapy: Nancy McWilliams Framework with Clinical Examples from the Tuesday Cohort

Dr. Bergink, a leading expert in women's mental health, joins the podcast to unpack the complex links between perimenopause and mental health, including new-onset or worsening depression, anxiety, panic attacks, brain fog, sleep disruption, and irritability driven by hormone fluctuations rather than simply low estrogen. Discussion surrounds evidence-based insights on distinguishing hot flashes from panic, the real benefits and limits of hormone therapy (HRT) versus SSRIs or CBT-I, myths about testosterone and surgical menopause, elevated risks in bipolar disorder, and why cognitive changes are usually temporary.

In this episode of the Podcast, Dr. David Puder is joined by psychiatric geneticist Dr. Consuelo Walss-Bass and Dr. Julio Licinio for a powerful conversation on the early signs, genetics, and treatment of schizophrenia. Drawing from her lived experience growing up with a mother and sister who both have schizophrenia, Dr. Walss-Bass discusses prodromal symptoms, the 287 risk genes identified by the Psychiatric Genomics Consortium, gene-environment interactions, challenges of early intervention, and why clozapine remains the gold standard for treatment-resistant schizophrenia.

In this essential episode of the podcast, Dr. David Puder and reproductive psychiatrist Dr. Katrina Furey interview pioneering expert Dr. Margaret Spinelli on postpartum psychosis, covering its symptoms, diagnosis, treatment, and prevention. They explore the history of perinatal psychiatry, neonaticide and dissociation, the critical need for mother-baby units, rapid symptom progression, why timely hospitalization and treatment lead to full recovery for most women and much more. Link to blog Link to YouTube video By listening to this episode, you can earn 1.25 Psychiatry CME Credits.

In this essential episode of the Psychiatry & Psychotherapy Podcast, Dr. David Puder sits down with internationally renowned expert Dr. Veerle Bergink, Director of Mount Sinai's Women's Mental Health Center, for an in-depth discussion of postpartum psychosis. Covering early warning signs and symptoms, differential diagnosis including anti-NMDA receptor encephalitis and thyroid issues, a highly effective acute treatment algorithm using benzodiazepines, antipsychotics, and lithium, the remarkable 98% remission rates with proper care, lithium's superior role in preventing relapse during the first postpartum year, the simple but powerful prophylaxis strategy of "baby out, lithium in" for high-risk women with bipolar disorder or prior episodes, the urgent need for mother-baby psychiatric units in the U.S., and the ongoing push to formally classify postpartum psychosis in the DSM.

In this episode, Dr. Puder talks with reproductive psychiatrist and psychoanalyst Dr. Alyson Gorun and Dr. Fredric Busch about postpartum depression and problem-focused psychodynamic psychotherapy. They focus on the five core conflicts (difficulty tolerating anger, idealized expectations of parenthood, struggles with dependence, fear of separation and abandonment, and fear of intrusion) that often underlie symptoms, shame, attachment reactivation, and stuck behaviors in the perinatal period. This episode explores: -How these dynamics emerge even when parents know what they "should" do -How to integrate psychodynamic insight with medication, sleep, social support, and evidence-based care -Practical ways clinicians can help mothers and fathers mentalize their experiences, reduce guilt, and improve bonding.