Catatonia in children and teens is underdiagnosed, frequently misunderstood, and potentially fatal if left untreated. In this episode, Dr. David Puder and Dr. Annabel Kuhn interview Dr. Joshua Ryan Smith—child and adolescent psychiatrist and division director at Vanderbilt University—to explore the essential clinical skills and medical knowledge needed to identify and treat pediatric catatonia.

You’ll learn how to differentiate catatonia from other neuropsychiatric conditions in both neurodivergent and neurotypical children, how to apply tools like the Bush-Francis and Pediatric Catatonia Rating Scales. This episode also unpacks common misdiagnoses in cases involving autism spectrum disorder, schizophrenia, and autoimmune or metabolic conditions. Finally, it offers practical, evidence-based guidance for both inpatient stabilization and outpatient follow-up care.

Whether you’re a psychiatrist, pediatrician, therapist, or student, this episode offers life-saving insights into one of the most overlooked syndromes in child psychiatry.

By listening to this episode, you can earn 1.0 Psychiatry CME Credits.

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In this episode, Dr. David Puder is joined by psychiatrist Dr. Eric Bender to explore the psychological depth of the Emmy Award-winning show, The Bear (FX). Through a psychodynamic lens, they examine Carmy’s character—his trauma, complex PTSD, obsessive-compulsive personality traits, and avoidant attachment style. They also break down the borderline dynamics in his family, especially his mother’s primitive defenses, identity diffusion, and projective identification.

The discussion covers dissociation, personality styles, sibling roles, and emotional neglect, drawing connections to clinical work and real-life therapy. This episode gives both clinicians and fans of the show a nuanced understanding of how early attachment, trauma, and family dynamics shape adult behavior.

Whether you're a therapist, student, or simply a fan of the show, you'll gain insight into how The Bear reflects complex inner worlds.

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Dr. David Puder and psychologist Dr. Jonathan Shedler explore depressive personality style—how it differs from clinical depression and why it often goes unrecognized. Through a detailed role play, they demonstrate how self-criticism, unconscious guilt, emotional deprivation, and suppressed anger emerge in therapy.

They discuss:

• How depressive personalities form in childhood

• The role of introjection, self-blame, and gentle idealization

• Why therapists may miss key dynamics if therapy feels “too good”

• How to help patients access their real needs and frustrations

This episode is ideal for clinicians and anyone interested in deep psychodynamic work. Shedler draws from the work of Nancy McWilliams and Otto Kernberg while offering his own insights on personality, countertransference, and therapeutic technique.

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By listening to this episode, you can earn 2 Psychiatry CME Credits.