How to Be Patient

How to Be Patient

You may have noticed a new trend lately. Everyone is loud and proud about their mental health struggles (and thank goodness)! For practitioners, this movement is as exciting as it is frustrating. As each mental health taboo falls by the wayside as it enters the cultural zeitgeist, a new aspect of our specialty thus emerges. One we just don’t have enough hours in the day to keep track of, let alone engage with. From better understanding our patients’ (and our own) relationships with their conditions in a changing world, it’s more important than ever that we learn: HOW TO BE PATIENT! Each week, join Dr. Preston Roche (Psychiatry Resident & Digital Influencer) and Dr. Margaret Duncan (Psychiatrist & Content Creator) on their quest to better understand the patients we dedicate our lives to and the evolving paths they’re bound to travel beyond the clinic. By engaging with stories and perspectives that challenge our shared understanding of a condition, we hope you’ll similarly gain new perspectives as we look at our patients, and their mental health struggles, with further nuance and empathy. (And with Dr. & Lady Glaucomflecken producing, we've been mandated to include plenty of weird medical jokes too). Speaking of which, a key part of this is hearing YOUR stories! What’s changed your understanding of patient care? Do you have an experience that shines new light on something we’ve discussed on-air? Get in touch at: howtobepatientpod.com

Episodes

What To Look For In A Psych Program (Season 2 Wrap)

November 10, 2025 • 64 mins
Margaret and I pivot into mentor mode a little in this episode, it’s targeted towards medical students and the vicissitudes of the match. We know these are tough times and we wanted to share some advice about what to look for in a psych program and how to pick a  place to train that is right for you. We also debrief the end of season 2 and take a wrap on 40 episodes! As always, thank you for listening! -- Watch on YouTube: @its...
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Acceptance and Commitment Therapy 101

November 3, 2025 • 75 mins
By popular demand, Margaret and Preston are back with another therapy episode. The topic this week? Acceptance and Commitment Therapy (ACT), a third wave behavioral therapy that Margaret happens to be trained in and love for her patients and her own life. In this episode we talk about the founder of ACT and its roots in behaviorism, what an ACT therapist “sounds like”, and the 6 core processes of psychological flexibility that enco...
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Trauma and Dissociation with Kristin Flanary (Lady Glaucomflecken)

October 27, 2025 • 76 mins
In this episode, we bring on Kristin Flanary, who is currently doing her own investigation into dissociations associated with trauma from both her own experience as a survivor and as an academic. We discuss the current media landscape of trauma and dissociation, the neurological mechanisms of dissociation, and therapeutic approaches clinicians can use with a patient who is experiencing dissociation. Citations: Modesti MN, Rapi...
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A Patient’s Perspective on Chronic Pain with Alexandra Wildeson

October 20, 2025 • 97 mins
Today we are joined by the host of the “calling in sick” a pod run by our good friend Alex (familiarly) to discuss the rigamoroll that is navigating the healthcare system through the eyes of a patient with debilitatig conditions. Alex shares her story from Investment banker, to patient to podcaster all the while coloring things with her own levity and resilience. -- Watch on YouTube: @itspresro Listen Anywhere You Podcast: Appl...
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Prescribing Laughter with Will Flannery (Dr. Glaucomflecken)

October 13, 2025 • 66 mins
This episode is a slight excursion from our regularly scheduled program. Today we are chatting with Will Flannery, who is in many ways our content “dad” if you will. We will talk about the art of including humor into our daily practive, when it goes right, when it goes left, and where we go from here. Dr. Glaucomflecken also has some fun and new projects he’d like to share with you at the end.  -- Watch on YouTube: @itspresro Li...
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Nutritional Psychiatry with Dr. Drew Ramsey (Part 2)

October 6, 2025 • 62 mins
Margaret and I are back with part two of our conversation with Dr. Drew Ramsey and this time, things get personal. I volunteered my real-life food log for a full nutritional psychiatry breakdown… and let’s just say my “ultra-processed protein” lifestyle did not escape unscathed. What started as a casual diet review turned into something deeper. A mentoring session about joy, creativity, and what it actually means to feed your brai...
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Nutritional Psychiatry with Dr. Drew Ramsey (Part 1)

September 29, 2025 • 69 mins
We sat down with Dr. Drew Ramsey to talk about something we all think we understand and don’t: how food shapes mood. In Part 1, we get practical and personal: what to reach for when you’re anxious, what to cook when you’re depressed, and how to think about nutrition when you’re busy, broke, or just not in the headspace to sauté anything. We talk simple swaps, what actually belongs on a “brain food” plate, and why perfection is the ...
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The Lithium Episode

September 22, 2025 • 75 mins
In this preston-led episode, we take a deep dive into the history of lithium and its use in psychiatry. But because Preston is very literal, we are starting at the very beginning, inside of stars where lithium was formed at the beginning of the universe. Then we will follow this wonderful atom through history and past its FDA approval in 1970 to where we are today.  Takeaways: Lithium was once sold in Seven Up as a mood-lif...
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Advocating from Inside the Prison System

September 15, 2025 • 80 mins
This week, Margaret and I sat down with Dr. Jhilam Biswas, psychiatrist and expert on the intersection of law and mental health, for one of the hardest—and most important conversations we’ve had on the show. Together, we take a close look at how our justice system responds to mental illness: what happens when people in crisis are incarcerated instead of cared for, and how the prison system has become a stand-in for mental health tr...
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Let’s Talk About Aphasias

September 8, 2025 • 53 mins
What is aphasia, really and what happens when your brain no longer cooperates with your ability to speak or understand language? In this episode, Preston and Margaret tackle the messy, frustrating, and often isolating world of language disorders, focusing on the real-life implications of aphasia. They walk through the clinical causes, what it looks like day-to-day, and how aphasia differs from other speech and cognitive issues. Al...
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Is My Pain All In My Head?

September 1, 2025 • 73 mins
Is it all in your head or is pain more complex than we’ve been led to believe? In this episode, Margaret and I dig into the psychological and biological factors that shape our experience of pain, including how the brain processes physical discomfort, the emotional toll it takes, and what role medications actually play. We also share stories from our own lives and clinical work that highlight how pain shows up in complicated, often ...
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Freud Enters the Chat: Psychodynamic Therapy

August 25, 2025 • 77 mins
Margaret took the captain’s chair for this one, and I was just along for the ride—straight into the deep waters of psychodynamic and psychoanalytic therapy. We start with the basics: what do these words actually mean, and why do they still make some clinicians roll their eyes while others swear by them? From Freud’s infamous couch to modern relational therapy, we unpack the myths, the methods, and the mysteries that still define th...
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Alyson Stoner: What Happens When You Grow Up in the Spotlight?

August 18, 2025 • 92 mins
This episode might feel like a gut punch, in the most important way. Margaret and I sat down with Alyson Stoner to talk about what it means to be raised in the spotlight, what happens when systems prioritize performance over people, and how we reckon with that legacy in healthcare. There’s a vulnerability here that caught me off guard and I think that’s the point. If you’ve ever wondered what lies beneath the polished performances ...
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Suicide Risk Assessments: Using Predictive Models in a Personalized Way

August 11, 2025 • 101 mins
Margaret and I sat down to speak on a topic we rarely hear spoken plainly: suicide. We didn’t plan to tidy anything up or wrap it in easy language. Instead, we tried to sit with it—the fear, the responsibility, the human ache behind it all. We talk about how suicide shows up in our clinical work, how it’s shaped us personally, and why we both believe silence helps no one. This isn’t a “how-to” or a lecture. It’s a real conversation...
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Religious Trauma and Broader Visions of Spirituality in Healthcare

August 4, 2025 • 61 mins
This episode felt like a deep exhale. Margaret runs solo today, as she sat down with Dr. Hillary McBride—psychologist, author, and researcher—to talk about embodiment, trauma, and the radical act of tuning back into ourselves. We talked about what it means to feel your feelings in your body, why disconnection often begins as protection, and how pleasure, presence, and play can be part of the healing process. It’s about more than c...
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Why People Die By Suicide: Theories Through History

July 28, 2025 • 71 mins
While in psychiatry we avoid using declarative or certain language about mechanisms, it can be helpful to think about the narratives that drive people to behavior that will ultimately end their life. In this episode Margaret and I review the Durkheim principles of suicidality following the four categories: anomic, fatalistic, egoistic and altruistic. We talk about how each has a distinct flavor in the clinical setting and which on...
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Eating Disorders for Psychiatrists: Part 2

July 21, 2025 • 52 mins
It’s Part 2 of our deep dive into eating disorders—and this time, we’re going even deeper. We kick off by unpacking our mock therapy session with Dr. Helen Liljenwall, which unexpectedly hit close to home for all of us. Then we take a sharp turn into the medical realities of starvation, including refeeding syndrome, the female athlete triad, and why your heart is always in the equation (literally). But what happens when patients r...
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Eating Disorders for Psychiatrists: Part 1

July 14, 2025 • 58 mins
This is Part 1 of our two-part deep dive into eating disorders—and we’re starting at the beginning. Margaret and I sit down with psychiatrist and eating disorder specialist Helen Liljenwall, MD to walk through the basics: What are the major types of eating disorders? What do they actually look like in real life? And how do we treat something that’s rooted in both biology and culture? We cover everything med school skipped—then try ...
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The History and Process of Psychiatric Detainment

July 7, 2025 • 74 mins
Margaret and I talk about what it feels like to care for patients who remind us a little too much of ourselves, especially when we’re also the ones filling out the paperwork for a psychiatric hold. We dig into what a 5150 (or 5585) really means, how to sit with that kind of authority, and the emotional mess of seeing a patient’s fear reflect your own. Psychiatric holds carry legal weight, but emotional weight, too. We talk abou...
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The History of Burnout (And Our Maslach Scores)

June 30, 2025 • 63 mins
In this episode, Margaret and I take on burnout—what it actually is, where the term came from, and how to tell when you’re not just tired, but something deeper is cracking. We dig into the history, the Maslach Inventory, moral injury, and why burnout isn’t in the DSM (yet). We also share our own unhinged burnout moments (yes, mine involves harmonica) and explore how to tell the difference between burnout, depression, and just being...
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