Good Enough Shrink

Hello listeners! Münchausen Syndrome or factitious disorder is a fascinating yet devastating topic that we’ve taken a few recordings to discuss, especially in light of the recent Florida appeals court ruling on the famous case of Maya Kowalski. As child psychiatrists, we hope to share with you that we are relentlessly searching for answers in conditions like this, and not giving up on the pursuit despite our own vulnerabilities. 

To...

Hello listeners! We are so excited to share this episode with you. We get into the nitty gritty of treatment for PTSD in both psychotherapy and medications. 

**This information is for general knowledge and does not substitute for professional medical advice, diagnosis, or treatment. Please always consult your own healthcare provider for your care.**

Psychotherapy

• Trauma-Focused CBT
• EMDR
• CPT, Prolonged Exposure, Narrative Exposu...

In this episode, we discuss how trauma symptoms present in children, the challenges of diagnosing and treating trauma in children, including the limitations of current diagnostic systems, and the neurobiology of trauma response. Lastly, we discuss marginalized groups to emphasize the most important part of recovery from trauma: not feeling alone. 

Topics Discussed:

• How trauma symptoms present in children 
• Developmental Trauma Diso...

Hello listeners! We are tackling the enormous topic of trauma. We start with how trauma response was stigmatized in history, PTSD's diagnostic criteria, overlap with other conditions such as cPTSD and borderline personality disorder, and the curious roles of memory in trauma. Enjoy!

Topics discussed:

• Shellshock, stigma of trauma
• Diagnosis based on the DSM
• Diagnoses not based on the DSM
• Prevalence
• Resources from the VA

Here i...

In this episode, we invite our good friend and colleague, Dr. Michael Couse, to discuss a recent paper that he and Dr. Kelly published in the academic journal, Journal of the American Academy of Child and Adolescent Psychiatry. The paper discusses the highly complicated (and often avoided) topic of electroconvulsive therapy (ECT) for youths with serious mental illness, especially in California. There are many fears and myths surrou...

Welcome to Season 2 of Good Enough Shrink! It has such a fun ride this past year. We are kicking off the new season with a topic that remains controversial in some areas of the country, electroconvulsive therapy (ECT). We want to dispel misunderstandings about this treatment, and provide accurate information for anyone who is wanting to learn more about ECT, which can often be lifesaving. 

Topics discussed:

• Stigma of ECT
• What is E...

Hello listeners! In this episode, I bring together neuroscience and everyday life  to present tips on how to communicate when you are feeling at your worst. Whether you are in an argument with your partner, a power struggle with your kid, or a disagreement with friends/coworkers, these concepts are universal and work in any situation. So if you feel like you are constantly in conflict with people, as life goes, take a listen! 

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In this episode, our goal is to bring you tools to understand and destigmatize addiction. We discuss the complexity of addiction at the biological, psychological and societal levels. So if you are ready to explore this complex topic, take a listen!

Topics Discussed: 

• Past and present definitions of addiction
• DSM-5's "Substance Use Disorder" - more than a checklist
• Biological, genetic, chemical aspects of addicti...

This episode starts with the various ways social media has changed how we view ourselves and others. We then discuss the sobering link between cyberbullying and suicide rates among young people. Finally, we bring you practical tips and ideas about how to fight bullying at the individual, school, state, and systems levels. You are not alone in this fight!

Topics discussed:

• Social media and its socio-cultural revolution 
• Bullying an...

Hello! We are back after a busy month at the clinic! In this episode, we discuss a very niche topic -- the different levels (or continuum) of care in mental health treatment. These acronyms can be so confusing for parents and families, so we hope to clarify them for you as you navigate what is the appropriate level of care for you or your loved ones. 

Topics Discussed:

• Overview of mental health continuum of care
• The importanc...

In this episode, we explore the impact of the Los Angeles wildfires on families and the individual person, emphasizing trauma-informed care and support for those affected by disasters. We also cover practical tips for disaster psychiatry, psychological first aid, and how to start an honest conversation with your kids about traumatic exposures.

Topics discussed:

• What is a disaster? 
• What is trauma? 
• Acute stress disorder vs PTSD 
• Ris...

In this episode, we discuss the challenges in dealing with the recent executive orders against the LGBTQ+ community. We go over the emotional toll of political rhetoric, the need for access to gender-affirming care in youth, and how important it is to slow down and examine gender dysphoria in children (and adults!) from a compassionate and open-minded perspective. We get personal talking about our struggles with the current politic...

This is a long-awaited episode! We talk about the difference between feeling lonely and being alone, and the biological mechanisms that drive humans to connect with each other. After we intellectualize it all (as doctors do), we get to the root of the problem in loneliness -- the importance of fostering a sense of safety. Join us in this exploration on how loneliness is deeply rooted in your attachment experience! 

Topics Discussed:

This week, we explore the curious and unnerving world of artificial intelligence (AI) and mental health. We discuss its potential benefits in healthcare for both psychiatrists and patients, as well as risks such as harmful content, liability issues, privacy issues, and blurring the line between what is real and fake. We are excited and wary of this new technology that is inevitably going to be in every aspect of our lives. Join us ...

Welcome to the new year! This episode is about how to approach making a change in your life. Your ambivalence, values, fears, and goals are all crucial parts of what makes you you. It's also important to just take a pause sometimes in this ever-changing world today. So I hope this quick episode will give you that pause and reflection to propel you toward what matters the most in your life! 

Have questions for us,...

Hello there! This episode is a dense one. We discuss neurosis and anxiety from the perspective of childhood and growth. We go over concepts of “basic anxiety” and “neurotic pride”, reflecting on healthy and unhealthy narcissism fueling anxiety as proposed by the psychoanalyst, Karen Horney. We explore how the DSM anxiety disorders are categorized, the importance of a holistic approach to treatment, and the use of medication in mana...

We are back! In this episode, we discuss the nitty gritty, fascinating details of schizophrenia and psychosis. We explore the devastating stigma associated with schizophrenia, the challenges of diagnosing and managing severe mental illnesses, and the importance of honoring the patient as a human being. Join us, as we three child psychiatrists chat about how to build trust and collaboration in mental health care, and keep the hope a...

Hello! We are continuing our conversation on psychosis. In this episode, we focus on differential diagnoses for psychosis, including medical and psychiatric conditions that can often be confused with a truly psychotic disorder like schizophrenia. Specifically, trauma is a big one, leading us to lose ourselves in the imbalance of imagination and reality. Especially in kids! Lastly, we talk about treatment of psychosis, our approach ...

Hello! This week, we delve into the fascinating history of how we conceptualize psychosis and schizophrenia. All those with schizophrenia have psychosis, but not all those with psychosis have schizophrenia. From a psychological framework to a biological one, the field of psychiatry has gone back and forth between the two and really struggled to understand schizophrenia. Now, we are just starting to see the interplay between genetic...