What makes Dr. Zhang’s perspective so disarming is that she refuses to treat death as a subject that requires hushed tones. She brings the same matter-of-fact warmth to a hospital room at Bellevue as she does to her writing and videos about her experiences working in end-of-life care. She and Dr. Reid also discuss how listeners can start on a path to less guilt and more meaning in their lives today.

Her ABCs of Deathbed Regret

Dr. Zhang shares the framework she returns to again and again at the bedsides of the dying. It’s not a list of regrets about money or career, but 3 quieter, more human wishes so many people have spoken about in their final days.

Authenticity. “I wish I had been more true to myself.” The regret of having lived as who was expected, rather than who they actually were.

Bravery. “I wish I had the courage to pursue my dreams.” The risk that felt too frightening to take, looked back on as the one that mattered most.

Connection. “I wish I had kept in touch.” The relationship left untended, or never repaired.

As Dr. Zhang puts it, her hope isn’t that we wait for a deathbed to feel the pull of one of these, but that we notice which one lands hardest right now, and treat that as the signal worth acting on.

About Dr. Luyi Kathy Zhang

Dr. Luyi Kathy Zhang is a hospice and palliative care physician, certified coach and hypnotist, author, and TEDx speaker. She is an assistant professor at NYU School of Medicine and directs the End of Life Serenity Unit at Bellevue, the nation’s oldest public hospital. Having sat with thousands of dying patients and heard their deepest secrets, biggest regrets, and final wishes, Kathy now shares that deathbed wisdom through her writing, speaking, and content, on a mission to help the rest of us start living the life we truly want, long before we reach the end of it.

Dr. Zhang’s Website: https://luyikathyzhang.com/

Her TEDx talk!

On Instagram as https://www.instagram.com/dr.luyikathyzhang

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Dr. Jennifer Reid is a physician, the host of A Mind of Her Own, and the author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations — available at major retailers.

🌐 Website: jenniferreidmd.com Instagram: @JenReidMD Threads: Jennifer Reid, MD

Feeling inspired by this conversation? Start your own Guilt-Free Group at jenniferreidmd.com/guilt-free-groups or download a book club guide at jenniferreidmd.com/book-clubs.

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-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:

The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

“I’m busy all day, but I don’t get anything done. I want something to show for my efforts.”

“Everyone in my life is tired of my lateness and unreliability.”

“I can’t get motivated unless I’m facing a deadline, and what I produce isn’t as good as it could be.”

In this episode of A Mind of Her Own with Jennifer Reid, MD, we hear from adult ADHD expert, J. Russell Ramsay, PhD about a new way of viewing ADHD: as fundamentally a self-regulation problem, not an attention problem. The name is misleading. What’s really impaired is the ability to organize behavior across time in order to consistently follow through on what you intend to do.

CBT adapted for ADHD works differently than standard CBT. The focus isn’t on changing negative thoughts. It’s on reverse-engineering the how of not doing things, then building explicit step-by-step plans. The goal is slowing down the executive function deliberately, making implicit steps external and visible.

The Core Executive Functions Affected in ADHD:

• Inhibition (pausing before responding automatically)

• Nonverbal working memory (mental simulation and planning)

• Verbal working memory (internal self-talk and staying on track)

• Emotional regulation and motivation (generating drive in the absence of immediate consequences)

• Reconstitution (flexible, creative problem-solving)

Emotional dysregulation is a core feature, but it’s invisible in the DSM. Emotions don’t appear in the diagnostic criteria at all, yet they drive much of what people actually struggle with: impulsive reactions, difficulty tolerating discomfort, and using guilt as a misguided motivator.

Women are significantly under-diagnosed and diagnosed later. CDC data from 2024 found that 50% of people with ADHD were diagnosed at age 18 or older, and 61% of those were women. Girls’ symptoms often appear on the playground rather than in the classroom, with social disruption rather than academic chaos, making them easier to overlook. Women are also more likely to be diagnosed first with anxiety or depression.

Self-mistrust is a hallmark and often mistaken for low confidence. After years of inconsistent follow-through, many adults with ADHD stop trusting themselves to do what they set out to do. This isn’t simply low self-esteem; it’s a learned pattern of doubting one’s own reliability, often amplified by the unspoken message: it must be something I’m doing wrong.

High functioning doesn’t mean unaffected. Many people mask symptoms for years through compensatory strategies: all-nighters, parental scaffolding, sheer willpower, until the scaffolding is removed or life demands multiply (new job, parenthood, caregiving, perimenopause).

Front-end perfectionism drives procrastination. The biggest cognitive distortion in ADHD isn’t negativity, it’s the belief that conditions must be perfect before starting. Waiting to feel focused, energized, or “in the mood” guarantees perpetual delay. The reframe: Do I have enough to begin?

ADHD also brings real strengths. Creativity, the ability to hyper-focus in stimulating environments, hands-on intuitive knowledge, persistence when engaged, and the capacity for innovative thinking are all genuine advantages, not consolation prizes.

Resources Mentioned

• Book: Once I Get Started: The Adult ADHD Program for Turning Your Intentions into Actions — Dr. Russell Ramsay (Avery/Penguin Random House, May 2025)

• Book: You Mean I’m Not Lazy, Stupid or Crazy?! — Kate Kelly & Peggy Ramundo (mid-90s classic, still widely cited)

• Book: The Power of Habit — Charles Duhigg (source of the “keystone habit” concept)

• Book: The Extended Mind: The Power of Thinking Outside the Brain — Annie Murphy Paul (on environment, cognition, and the need for solitude)

• Book: Living Well with Adult ADHD: Practical Strategies for Improving Your Daily Life — Dr. Laura Knouse & Dr. Russell Barkley (Guilford Press, 2025)

• Researcher: Dr. Margaret Sibley — Professor of Psychiatry & Behavioral Sciences, University of Washington; leading work on adult ADHD diagnosis guidelines through the American Professional Society of ADHD and Related Disorders (APSARD)

• Researcher: Dr. Russ Barkley — foundational work on ADHD as executive dysfunction

• Assessment tool: QB Test (Qbtech) — computerized continuous performance task used to objectively measure attention, impulsivity, and activity

• Website: cbt4adhd.com — Dr. Ramsay’s practice, contact form, and resources

About Dr. Russell Ramsay

Dr. J. Russell Ramsay is a licensed psychologist and board-certified cognitive-behavioral therapist specializing in the assessment and psychosocial treatment of adult ADHD. He was the co-founder and co-director of Penn’s Adult ADHD Treatment and Research Program, one of the earliest and most influential programs of its kind, established in 1999.

Dr. Ramsay is the author of six books on adult ADHD, including his most recent, Once I Get Started (2025). He has lectured internationally, published extensively in peer-reviewed journals, and serves on the editorial board of the Journal of Attention Disorders. He is an inductee in the CHADD Hall of Fame and recipient of the University of Pennsylvania’s Szuba Award for Excellence in Clinical Teaching and Research. He now runs a fully virtual solo psychology practice, licensed in Pennsylvania and credentialed through PsyPact to practice telepsychology across 35+ participating states.

🌐 cbt4adhd.com

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Download the free app at the link above or at: https://learnatpinnacle.com/education

Connect with your host, Jennifer Reid, MD

Dr. Jennifer Reid is a physician, the host of A Mind of Her Own, and the author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations — available at major retailers.

🌐 Website: jenniferreidmd.com Instagram: @JenReidMD Threads:

Feeling inspired by this conversation? Start your own Guilt-Free Group at jenniferreidmd.com/guilt-free-groups or download a book club guide at jenniferreidmd.com/book-clubs.

If you live in NJ and PA and would like to learn more about Dr. Reid’s unique mental health treatment, contact assistant@jenniferreidmd.com

If you enjoyed this episode, please follow A Mind of Her Own and leave a rating or review on Apple Podcasts — it makes a huge difference in helping other people find the show! 🎙️

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255
Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:

The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

“Every woman deserves the chance to have a real discussion about hormone therapy — and make whatever decision is right for her. I’m here to give information and answer questions. It’s your body.”

— Dr. Jacqueline Riedel

The doctor who finally has time for you

Dr. Jacqueline Riedel, DO spent 15 years in family medicine where she learned this: women’s hormonal health in midlife was profoundly under-treated and misunderstood. In a busy hospital-based clinic, she’d start a long-overdue conversation with a patient about perimenopause symptoms… and have to cut it off because the schedule demanded it.

So she left. She opened Magnolia Midlife Women’s Health, a direct-care practice built on something simple but radical: unhurried, conversational visits where women can actually ask their questions, get real answers, and leave feeling seen.

In this conversation, she covers what’s really happening hormonally in your 30s, 40s, and 50s and why everything you were told to fear about hormone therapy probably isn’t the full story.

Perimenopause starts earlier than you think

Dr. Riedel sees women with perimenopause symptoms long before any changes in the menstrual cycle. If you’ve been dismissed, or told your symptoms are just stress or mom-brain, you’re not alone. Symptoms she commonly sees:

• New insomnia: can’t fall asleep or waking for no apparent reason

• Anxiety, often misread as “just life stress”

• Persistent, unexplained fatigue

• Hot flashes and night sweats

• Mood changes including irritability, low mood, brain fog

• Cycle irregularities such as heavier periods, irregular timing

Dr. Riedel’s approach: map symptoms to your cycle. When do they happen? Are there patterns? She also rules out other common causes, including thyroid issues and iron deficiency before exploring hormone therapy as an option.

MYTH BUSTING

The fears holding women back from relief

Two decades after the Women’s Health Initiative (WHI) study was misread and sensationalized, fear still dominates the conversation around hormone therapy. Dr. Riedel sets the record straight.

Myth 1: Hormone therapy causes breast cancer.

Fact: Long-term WHI follow-up showed women in the hormone treatment group had lower rates of breast cancer. Even a first-degree family history is not a contraindication. And if breast cancer does occur in someone using MHT, their risk of dying is actually lower than in those not using it.

Myth 2: The doses in MHT are dangerously high.

Fact: Menopausal hormone therapy doses are far lower than those in oral contraceptive pills. If you’d prescribe the pill, you can’t logically call MHT dangerous.

Myth 3: Vaginal estrogen has systemic effects and should be avoided in cancer history.

Fact: Topical vaginal estrogen has negligible systemic absorption. It reduces UTIs, yeast infections, urinary frequency, and pelvic floor dysfunction, even in women under active breast cancer treatment, per emerging oncology research. The FDA recently removed the black-box warning.

TREATMENT OVERVIEW

How Dr. Riedel approaches care

There’s no single protocol. Dr. Riedel listens first, identifying the top two or three symptoms most affecting quality of life, and builds from there.

Progesterone for sleep & anxiety

• Stimulates GABA production, a calming neurotransmitter

• Helps with sleep onset and staying asleep

• Reduces the racing mind at 2am

• Often the first place she starts

Estrogen for vasomotor symptoms

• Addresses night sweats, hot flashes, palpitations

• Keeps estrogen levels from dropping to “empty”

• Preferred as transdermal (patch, gel, spray) to avoid blood clot risk

• Added when progesterone alone isn’t enough

Vaginal estrogen for urogenital health

• Reduces painful intercourse and dryness

• Decreases UTIs and yeast infections

• Supports pelvic floor health long-term

• About 50% of women need this even on systemic estrogen

Non-hormonal options when hormones aren’t right

• Newer medications targeting particular neurons in the hypothalamus (hot flash regulation)

Things you can do and questions to ask

Dr. Riedel’s conversation offers practical starting points for women navigating this transition on their own or with a provider.

01. Track your symptoms in relation to your cycle

Sleep disruption, anxiety, and mood changes that follow a cyclic pattern are often hormonal in origin. Note when in your cycle you feel worst because this information is gold for any provider visit.

02. Ask your doctor to rule out thyroid and iron first

Fatigue, brain fog, and sleep issues can also come from iron deficiency or thyroid dysfunction. Simple labs can clarify what you’re actually dealing with before hormones enter the picture.

03. Reconsider what’s in your sleep toolkit

Alcohol before bed worsens sleep, hot flashes, and anxiety, even though it feels like it helps. Benadryl/ZQuil, Ambien, and benzodiazepines disrupt true sleep architecture. CBT for insomnia has strong evidence and virtually zero side effects.

06. Consider this a second puberty — not a decline

Midlife is a genuine developmental threshold. Dr. Riedel and Margaret Mead’s concept of “postmenopausal zest” both point in the same direction: this can be a time of clarity, reclaimed energy, and real possibility if you get the support your body actually needs.

REFERENCES & RESOURCES

[Podcast] Kelly Casperson, MD — You Are Not Broken

Urologist and leading voice in the menopause space. Dr. Riedel’s “gateway” into this field. Highly recommended for patients and providers alike.

[Course] Rachel Rubin, MD — Physician Webinar Series

Sex medicine specialist and urologist based in Washington, D.C. Physician-only course covering the science of hormones, common fears, and evidence-based prescribing. Her tagline: “What are you afraid of?”

[Course] Heather Hirsch, MD — Menopause Education

A well-regarded course for providers wanting to build competence in this space.

[Organization] The Menopause Society (formerly NAMS)

Membership, certification exam, slide decks, and a comprehensive textbook. menopause.org

[Supplement Review] Labdoor.com

Independent third-party testing of supplement brands for purity and label accuracy.

FIND DR. RIEDEL

Magnolia Midlife Women’s Health

A direct-care practice built for women who are tired of feeling rushed, dismissed, and underserved. Long visits. Real conversations. Evidence-based care from a physician who actually gets it.

Free 15-min consult Not sure if you need this kind of care? Book a quick call to talk through your symptoms and see if Magnolia is the right fit.

Website: magnoliamidlife.com

Instagram: @magnolia_midlife

Upcoming Event — June 30 Free public lecture at the Haddonfield Public Library: “Is It a Fad?” An evening on perimenopause, evidence, and what women deserve to know. Register through the library website.

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Connect with Your Host, Dr. Jennifer Reid

Dr. Jennifer Reid is a physician, the host of A Mind of Her Own, and the author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations — available at major retailers.

🌐 Website: jenniferreidmd.com Instagram: @JenReidMD Threads: @JenReidMD

Feeling inspired by this conversation? Start your own Guilt-Free Group at jenniferreidmd.com/guilt-free-groups or download a book club guide at jenniferreidmd.com/book-clubs.

If you live in NJ and PA and would like to learn more about Dr. Reid’s unique mental health treatment, contact assistant@jenniferreidmd.com

If you enjoyed this episode, please follow A Mind of Her Own and leave a rating or review on Apple Podcasts — it makes a huge difference in helping other people find the show! 🎙️

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255

Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:

The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

Dr. Weissman co-developed Interpersonal Psychotherapy (IPT) alongside her late husband, Dr. Gerald Klerman, on a simple premise: that human suffering is deeply tied to human connection. Grief. Conflict. Loneliness. Life upended. These are not niche clinical categories, but rather a universal language of distress. And IPT was built to respond to it.

In this conversation, Dr. Weissman reflects on five decades of research, the pandemic-era project that became a sweeping global volume (now available free via open access), and what it means to build something that outlives its origins.

*This episode briefly mentions suicide.

(Re-post: This is one of our most beloved episodes, brought back by popular demand. If you’ve heard it before, we hope it moves you just as much the second time.)

What Is Interpersonal Therapy (IPT) and Why Does It Work?

IPT links the emergence of psychiatric symptoms to what is happening in a person’s current life. It focuses on four core problem areas:

1. Grief — the loss of a loved one

2. Disputes — conflict with someone important to you

3. Transitions — life changes, even positive ones, that disrupt relationships

4. Loneliness/Isolation — chronic or newly developed lack of attachment

These four areas have proven to resonate across vastly different cultures because they reflect fundamental aspects of the human condition. Dr. Weissman emphasizes that IPT is not the only evidence-based psychotherapy — it is “one tool in the toolbox, not a religion.”

IPT for Adolescents

Adolescence is a prime time for IPT’s problem areas, especially disputes, transitions, and loneliness. Key takeaways for parents:

• Try to understand the specific stressors behind an adolescent’s symptoms rather than reacting to global, dramatic statements.

• Always be alert to the possibility of suicidal ideation.

• Communication barriers between teens and parents are common; a trusted third party (grandparent, therapist, family friend) can sometimes serve as a valuable bridge.

The New Book: IPT Around the World

This book is now available open access for readers everywhere!

The COVID-19 pandemic gave Dr. Weissman the unexpected opportunity to connect with IPT practitioners worldwide. What began as a routine update to the standard IPT manual grew into a sweeping collaborative volume covering more than 30 countries across Africa, Asia, Europe, and the Americas.

Contributors were asked: What are you doing? What works? What doesn’t? What adaptations did you need to make?

Notable chapters include:

• Uganda — IPT was introduced around 2003 amid civil war and a mental health crisis. A landmark clinical trial published in JAMA confirmed its effectiveness. Sean Mabry, a former WHO worker, went on to treat hundreds of thousands of people using IPT, even by telephone during the pandemic, and has now established a low-cost program in New Jersey.

• China — After government engagement and training by Columbia experts, IPT became what practitioners called a “rapidly growing practice,” with books, training programs, and internet-based delivery.

• Malaysia — IPT has been applied with refugees, using the “transitions” framework to help people process displacement and profound loss.

• Africa (Ethiopia, Kenya, Mozambique, Senegal, Zambia, Uganda) — Adaptations have been made for cultural context, including how disputes are communicated and resolved within different family and community structures.

• Japan and Hong Kong — Initial resistance to psychotherapy has given way to growing acceptance and translated materials.

• United States special populations — Chapters cover Alaska Natives, people who are incarcerated, sexual and gender minorities, pre-adolescents, adolescents, and older adults.

Cultural Adaptations

Dr. Weissman shares a vivid example from Uganda: women in marital disputes are often encouraged not to confront their husbands directly, but to work through an elder who mediates. The underlying IPT principle, that the dispute is driving the symptoms, remains intact; only the implementation changes.

Resources Mentioned

• International Society of Interpersonal Psychotherapy (ISIPT) — volunteer-run, affordable membership, biannual international conference (10th meeting held in the UK, March 2024)

• Dr. Weissman’s new book on IPT across international sites — published Open Access, freely available to practitioners and researchers worldwide

• Oxford University Press — publisher of the standard IPT manual

About the Guest

Dr. Myrna Weissman is the Diana Goldman Kemper Family Professor of Epidemiology and Psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons and Mailman School of Public Health, and Chief of the Division of Translational Epidemiology at the New York State Psychiatric Institute. Alongside her late husband, Dr. Gerald Klerman, she co-developed Interpersonal Psychotherapy (IPT), now backed by over 140 clinical trials, translated into numerous languages, and recommended by the World Health Organization.

🎙️Some Exciting News!

A Mind of Her Own has recently joined the Learn At Pinnacle app, so if you work in health care, you can receive FREE CE credit just for listening!

(This includes Category 1 AMA CME credit and many others.)

Download the free app at the link above or at: https://learnatpinnacle.com/education

Connect with Your Host, Dr. Jennifer Reid

Dr. Jennifer Reid is a physician, the host of A Mind of Her Own, and the author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations — available at major retailers.

🌐 Website: jenniferreidmd.com Instagram: @JenReidMD Threads: @JenReidMD

Feeling inspired by this conversation? Start your own Guilt-Free Group at jenniferreidmd.com/guilt-free-groups or download a book club guide at jenniferreidmd.com/book-clubs.

If you live in NJ and PA and would like to learn more about Dr. Reid’s unique mental health treatment, contact assistant@jenniferreidmd.com

If you enjoyed this episode, please follow A Mind of Her Own and leave a rating or review on Apple Podcasts — it makes a huge difference in helping other people find the show! 🎙️

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255

Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)

-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:

The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

- Carolyn Roy-Bornstein, MD

In this rich conversation, host Dr. Jennifer Reid welcomes Dr. Carolyn Roy-Bornstein, pediatrician, former nurse, passionate advocate for narrative medicine, and author of A Prescription for Burnout: Restorative Writing for Healthcare Professionals. Together, they explore how reflective writing can serve as a genuine antidote to clinician burnout. Drawing on her own experience navigating her son’s traumatic brain injury, decades of medical practice, and hundreds of writing workshops, Dr. Roy-Bornstein makes a compelling case that putting pain into language is not a luxury. It’s a tool for life.

🎙️Some Exciting News!

A Mind of Her Own has recently joined the Learn At Pinnacle app, so if you work in health care, you can receive FREE CE credit just for listening!

(This includes Category 1 AMA CME credit and many others.)

Download the free app at the link above or at: https://learnatpinnacle.com/education

Key Topics

• What narrative medicine actually means and how Rita Charon’s framework at Columbia centers the patient’s story as the foundation of clinical practice

• The neuroscience behind reflective writing: why naming painful emotions deactivates distress regions in the brain, and why just 15 to 20 minutes a day for four days can produce lasting relief

• How Dr. Roy-Bornstein’s son’s accident, a devastating drunk-driving crash that left him with a serious traumatic brain injury and took his girlfriend’s life, became the crucible for her own writing practice and public advocacy

About Dr. Carolyn Roy-Bornstein

Dr. Carolyn Roy-Bornstein is a board-certified pediatrician, former practicing nurse, and Writer in Residence at the Lawrence Family Medicine Residency Program, where she champions a narrative medicine curriculum. She is also the author of several books, including, most recently, A Prescription for Burnout: Restorative Writing for Healthcare Professionals.

Her website for more information on her latest book, A Prescription for Burnout: Restorative Writing for Healthcare Professionals, with nearly 100 writing prompts, and a schedule of upcoming workshops: carolynroybornstein.com

Connect with Your Host, Dr. Jennifer Reid

Dr. Jennifer Reid is a physician, the host of A Mind of Her Own, and the author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations — available at major retailers.

🌐 Website: jenniferreidmd.com Instagram: @JenReidMD Threads: @JenReidMD

Feeling inspired by this conversation? Start your own Guilt-Free Group at jenniferreidmd.com/guilt-free-groups or download a book club guide at jenniferreidmd.com/book-clubs.

If you enjoyed this episode, please follow A Mind of Her Own and leave a rating or review on Apple Podcasts — it makes a huge difference in helping other people find the show! 🎙️

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255

Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:
The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

Interestingly, however, one area that I believe hasn’t been discussed enough is the optimal duration of care psychiatrists should provide, at least in some settings. I can’t recall any training in this area, with time-limited psychotherapy protocols discussed, but ongoing, long-term care, whether it involved therapy or just medication check-ins, seemed to be the norm.

As I reflect on the variety of places I’ve practiced, including a county clinic caring for the chronically mentally ill and unhoused of West LA, to an academic center in Philadelphia where I saw professors, students and referrals from community psychiatrists of their most challenging patients, none of these settings focused much on duration of care.

In the county clinic, we would see individuals for as many sessions as we could, charts riddled with brief “no show” notes and walk-in visits for urgent medication refills. The academic setting was mixed. I saw some patients in our general outpatient clinic for the duration of my tenure, while others passed through before moving, graduating, or losing their insurance, which was always the most painful situation. There were very few true treatment “graduations.”

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I’ve had the chance to step into the culture of another specialty, as a consultant in a general family medicine clinic (Just as an aside: my father practiced family medicine in rural North Dakota throughout my childhood). I would hear the residents’ presentations and try to provide helpful guidance for medication choices, managing complex personality issues or suggesting referrals to a higher level of care. Occasionally, I would step into the room to interview a patient, but their future care was provided by the family medicine resident. This was also the case when I joined our academic center’s first foray into a collaborative care model, with psychiatrists available for consultation but not directly caring for patients. Teaching was both direct as well as implicit in my tendency to think out loud about difficult cases in our regular meetings.

More recently, I’ve been in private practice, where what I’ve witnessed would best be described as an enormous bottle-neck. Early on, I filled my telehealth roster and then spent hours each week providing lists of possible referrals, often to clinicians who were also packed to the point of exhaustion, and telling struggling individuals that I was so sorry, but I couldn’t help them further. Discussions around moral injury during COVID and since have typically focused on the high-stakes environment of the emergency room and ICU, but this pattern of perpetually disappointing people in need was a powerful recipe for burnout for many of us. I tried to focus on the individuals I could see, and the positive changes I could witness, but I still found this position incredibly demoralizing. Determined to find something better, I set out to design a practice that would be sustainable, both for my sense of well-being as well as addressing some of the bigger challenges in behavioral health today.

My exploration of options was taking place as the field changed around me. As the shortage of psychiatric care worsened, it makes sense that private equity and technology companies moved in to take advantage of the massive demand that existed. Listening to an advertisement for one of the biggest online providers, they understandably emphasize the ability to see someone almost instantly, for a duration of your choosing, at a cost that’s feasible. Coaching has also experienced rapid growth as people seek out support with clear goals and less stigma than treatment in a behavioral health clinic. However, these options are not without their own limitations, and certainly not able to address all of the present care needs.

I think, as psychiatrists, we have the opportunity to adjust our approach in this modern treatment environment. Yes, some patients require ongoing treatment with a trusted physician, preventing relapse as long as possible, and addressing symptoms when they do recur. However, some individuals might actually prefer (and respond well to) a different approach. Focused, evidence-based treatment can be provided by us as specialists, just as it is in many other fields, whether this involves medication assessment and initiation, de-prescribing, and/or psychotherapy.

With this in mind, I’m proposing a new kind of outpatient psychiatry: time-limited specialty care in the private practice setting, followed by a return to their primary care provider with a comprehensive report of our work together. In my own practice, I plan to provide 12 weeks of Interpersonal Therapy, a very well-studied approach to women’s depression, particularly around reproductive transitions, as well as CBT for Insomnia, the recommended treatment for insomnia by the American Academy of Sleep Medicine. So many women, particularly in the chaos of parenting and the adjustments of perimenopause, struggle to get quality sleep, and CBT-I providers can be few and far between. In addition, I will help individuals lessen constant feelings of guilt through my Guilt Free protocol, and offer medication optimization, whether this means a recommended addition or simplification of a regimen, as indicated.

I don’t see this treatment approach as conflicting with current practices, but rather complementing the efforts of my peers. The report for the primary care clinician will contain my recommendations for further medication adjustments, if needed, as well as a summary of assessments used throughout our treatment, including the Insomnia Sleep Index, among others. Rather than viewing a referral to psychiatry as a distant and hidden path for their patients, they can view it as a collaborative, focused treatment option, while witnessing their progress overcoming depression, anxiety, insomnia and other challenges.

As I speak with trainees in a variety of fields, it’s clear that there’s an appetite for something new in mental health care delivery. With this treatment approach, I hope to create just one additional option for them to consider.

Dr. Jennifer Reid is a psychiatrist in private practice, a clinical assistant professor at the University of Pennsylvania and a clinical associate professor at Cooper Hospital of Rowan University. She is also the host of A Mind of Her Own, and the author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations, featured in The New York Times and chosen as a 2026 ‘must-read’ by The Next Big Idea Club.

🌐 Website: jenniferreidmd.com 📸 Instagram: @JenReidMD 🧵 Threads: @JenReidMD

Feeling inspired by this conversation? Start your own Guilt-Free Group at jenniferreidmd.com/guilt-free-groups or download a book club guide at jenniferreidmd.com/book-clubs.

To learn more about Dr. Reid’s clinical practice (in NJ and PA), go to jenniferreidmd.com/philosophy

“I don’t think we move past challenging experiences. I think we integrate them into our identities and into the wisdom we carry forward.” -Dr. Rebecca Thompson

In Held Together: A Shared Memoir of Motherhood, Medicine, and Imperfect Love, Dr. Rebecca Thompson, family medicine and public health physician, weaves her personal story of life-threatening pregnancy complications into the stories of twenty-one patients, friends, and medical colleagues. Through profoundly honest and emotionally raw accounts, the book creates a space for connection, offering comfort to anyone touched by challenges in building or sustaining families.

At its heart, Held Together aims to expand the understanding of motherhood’s true diversity, while advocating for empathy, inclusion, and improved support for all women and families.

Storytelling as healing Several of Dr. Thompson’s collaborators shared that working on the book was the first time they had ever told their story in a coherent, cohesive way, and that the process allowed them to integrate the experience rather than feel stuck in it. Dr. Thompson draws a distinction between “moving past” challenges and carrying them forward with purpose.

Building community, one relationship at a time Near the close of the episode, Dr. Thompson reflects on what it takes to build real community: patience, persistence, and the willingness to start small. Most of Held Together was written in 20-minute windows, in parking lots, between appointments, in the in-between moments of a full life. The book itself is proof that small, consistent actions can accumulate into something meaningful.

References & Resources

Book: Held Together: A Shared Memoir of Motherhood, Medicine, and Imperfect Love by Rebecca N. Thompson, MD Available through affiliate links on Dr. Thompson’s website (a portion of proceeds benefits Postpartum Support International), through your local independent bookstore, or your library.

Postpartum Support International — an organization supporting maternal and family mental health: postpartum.net

Kintsugi — the Japanese art of repairing broken ceramics with gold lacquer, referenced in the book as a metaphor for post-traumatic growth and finding beauty in imperfection.

Connect with Dr. Thompson

Rebecca N. Thompson, MD, is a family medicine and public health physician from Portland, Oregon, who specializes in women’s and children’s health. She is the author of Held Together: A Shared Memoir of Motherhood, Medicine, and Imperfect Love, a collaborative project more than a decade in the making.

🌐 Website: www.rebeccanthompson.com (Note: The N is important, there are other authors named Rebecca Thompson! Look for the middle initial.)

📘 Facebook: facebook.com/rebecca.thompson.354831 📸 Instagram: @rebecca.n.thompson 🧵 Threads: @rebecca.n.thompson 💼 LinkedIn: Rebecca N. Thompson, MD

Connect with Your Host, Dr. Jennifer Reid

Dr. Jennifer Reid is a physician, the host of A Mind of Her Own, and the author of Guilt Free: Reclaiming Your Life from Unreasonable Expectations — available at major retailers.

🌐 Website: jenniferreidmd.com 📸 Instagram: @JenReidMD 🧵 Threads: @JenReidMD

Feeling inspired by this conversation? Start your own Guilt-Free Group at jenniferreidmd.com/guilt-free-groups or download a book club guide at jenniferreidmd.com/book-clubs.

If you enjoyed this episode, please follow A Mind of Her Own and leave a rating or review on Apple Podcasts — it makes a huge difference in helping other people find the show! 🎙️

A Note for Educators & Helping Professionals

Dr. Thompson is actively expanding her work into medical and health professions training. She welcomes outreach from educators working with medical students, residents, nurses, doulas, midwives, social workers, and psychologists, or anyone who wants to help the next generation of caregivers better understand their patients’ full context. Virtual presentations are available. Reach out through the Connect page on her website.

Please remember: your hosts are physicians, but we are not your physicians. For any personal healthcare concerns, please reach out to your own provider. You can also contact the mental health helpline by dialing 988. All opinions are the host’s and guest’s alone.

-Dr. Nikki Pensak, PhD, PMH-C

In this episode of A Mind of Her Own, Dr. Jennifer Reid, host and author of Guilt Free, sits down with Dr. Nikki Pensak, clinical psychologist, perinatal mental health specialist, and author of Rattled: How to Calm New Mom Anxiety with the Power of the Postpartum Brain (Paperback arrives April 14th!) Together they explore the science behind how a woman’s brain radically transforms during pregnancy and the postpartum period, why this developmental phase has a name (matrescence), and why virtually no one is talking about it.

Dr. Pensak shares her own deeply personal story of experiencing postpartum depression twice, including a severe episode with symptoms of OCD during COVID while her son was in the NICU, and how hitting rock bottom as a mental health expert motivated her to write the book she wished had existed. This episode is a must-listen for anyone who is pregnant, postpartum, or supporting a new mother.

Dr. Pensak’s Three Moves to Matrescence

1. Plan It

From the moment you find out you’re pregnant, establish care with a mental health provider or prescriber who specializes in perinatal mental health. Get a baseline assessment, understand your unique risk factors, and have your support system in place before the baby arrives, not after.

2. Name It

Understand that what you’re going through is matrescence, a recognized, science-backed developmental phase. Name the identity changes, the emotional upheaval, the relationship stress. Knowing it has a name, and that it is expected, is itself therapeutic.

3. Use It

Once mental health is stabilized, harness the brain’s remarkable neuroplasticity. Rise to challenges, pursue positive emotional experiences, and lean into post-traumatic growth. Your brain is primed for new learning. It’s time to use that superpower.

Resources Mentioned

Rattled: How to Calm New Mom Anxiety with the Power of the Postpartum Brain by Nicole Pensak, PhD, PMH-C. Available in hardcover, paperback (new cover, releasing April 14), audiobook, and Kindle.

Connect with Dr. Pensak: @drnikkipensak on all platforms

Guilt Free: Reclaiming Your Life From Unreasonable Expectations by Jennifer Reid, MD. Available now, including audiobook (read by the author) and e-book.

*Consider leaving a book review — it makes a huge difference for authors!

• Postpartum Support International (PSI) — free support groups for new mothers, fathers, anxiety, depression, and more. Also maintains a searchable database of certified perinatal mental health providers by state. https://www.postpartum.net

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Dr. Nicki Pensak is a clinical psychologist who specializes in treating postpartum mental health conditions, anxiety, OCD, depression, sexual dysfunction, and symptoms and side effects associated with medical issues (such as cancer and chronic medical conditions).

Dr. Pensak received her Ph.D. in Clinical Psychology from University of Rhode Island and completed her APA accredited internship and specialty training in behavioral medicine at Yale School of Medicine. She completed a postdoctoral fellowship at Massachusetts General Hospital/ Harvard Medical School in psychiatric oncology and an NIH T32 fellowship at the University of Colorado, Anschutz Medical Center in Aging and Palliative Care.

She currently serves on the Expert Review Board of Parents Magazine and is the author of RATTLED, How to Calm New Mom Anxiety with the Power of the Postpartum Brain. Dr. Pensak provides in-person therapy in Monmouth County, NJ and telehealth therapy in 40 states, nationwide.

Reminder: Both the host and guest are healthcare professionals, but they are not your healthcare professionals. Please consult your own providers with any personal medical or mental health questions.

Disclaimer: This podcast is for informational purposes only and does not constitute medical or psychological advice. If you are experiencing symptoms of postpartum mental health conditions, please reach out to a qualified healthcare provider or contact Postpartum Support International at postpartum.net. You can also contact the mental health helpline by dialing 988.

Medicine was not designed for us. It was designed by men, for men, with the expectation that the career was sustainable only with the support of full time staff at home, most often a wife. We were told we needed to conform to this model (well, first we were told we didn’t belong in medicine at all, but fortunately, many woman knew that was idiocy) and we did. We worked our asses off to graduate at the top of our classes, we dove into the competitive environment asking us to demonstrate effortless perfection if we didn’t want to risk our very presence in this lauded profession. We’ve worked when we were sick, postpartum and exhausted, caring for our children, our parents, our friends, our community. We’ve missed countless daytime school events because the world simply cannot catch up to the fact that the majority of physician women work during the day. We are reminded of the massive needs of patients anytime we try to request time off, as if staffing shortages and poor planning have been our neglected responsibilities.

We have tolerated these difficulties because we were told this is what medicine looks like. This is what it takes to be a doctor. In fact, this is dedication, compassion, following a true calling to help people. If we are destroyed in the process, well, maybe we weren’t really meant to be here at all.

But listen to me now. This is not dedication. This is survival, and the reason we’ve complied is because we’ve been taught to feel guilty, and then we’ve had this guilt weaponized against us. Modern medicine does not run on efficiency or even common sense. It runs on the backs of women who have been taught that they must always say “yes” to forever justify their presence in the profession.

Women in medicine are not burning out because we’re weak. We’re burning out because we have been systematically socialized to accept an increasingly broken system rather than coming together to name it, reject it, and demand something better.

This guilt keeps women from asking for adequate administrative time so we aren’t charting until midnight. It stops us from demanding a fair schedule or setting limits on the number of quality metrics we must document in ever-shorter patient care visits. Guilt tells us we need to turn inward to find the energy or dedication when we are confronted with a patient sitting across from us who needs more from one visit than we could possibly provide. Guilt tells us to absorb the blame for a system that, by prioritizing the bottom line for insurance companies rather than the health of communities, rejects necessary medications or surgical interventions and it’s up to us to appeal these decisions with time we don’t have. Guilt tells us we should be doing more, because the system isn’t working and it’s OUR FAULT.

A disturbing number of women physicians are either leaving clinical medicine or seriously contemplating leaving. Right now, for the administrative leaders in health care settings, guilt is a feature, not a bug. It keeps women giving more than they should, teetering on exhaustion and burnout, and blaming ourselves for the problems created far outside of the clinical encounter. What we absolutely don’t need right now is a performative expression of gratitude on one calendar day. We don’t need yoga classes or free cookies in the conference room. I’m so tired of hearing about resilience training that places the onus for change on the individual instead of the institution. Frankly, we are already resilient enough, or we wouldn’t still be here.

Women in medicine have power. Our patient outcomes and patient satisfaction scores are better, we spend more time with patients (not that this is rewarded. Often, just the opposite) and we are more likely to be contacted with questions and concerns. Medical schools are full of ambitious, smart, hard-working young women who are entering the field at a very difficult time, but by working together, we can start a movement for desperately needed change. I wrote Guilt Free because I’m done blaming myself, and you should be, too. We are decidedly not the problem.

So, I say, keep your Physician Day with its lukewarm, performative statements of gratitude. We demand something better.

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After a lifetime of chasing achievements and measuring my validity by outside measurements: medical school admissions, residency matches, job promotion, I was struggling to see myself as a success in this endeavor. I felt like I hadn’t done “enough,” even though I wrote a whole damn book, which is available across the country, including at my local library (which is, honestly, one of the most exciting parts. Every time I go in there, if my book isn’t checked out, I shamelessly display it more prominently in the new nonfiction section. My kids are in on it too. “Did you move your book yet, Mom?” “No, kiddo, it was checked out! Isn’t that amazing?”)

Some aspects of my disappointment and guilt are adaptive (my psychiatry brain says) because feeling dissatisfied pushes me to grow, to challenge myself. It reminds me that in order for the ideas I’ve written about to make a difference, people have to be aware that they exist. I have to set aside my general discomfort with self-promotion and quiet my self-doubt, even as it tells me, “you haven’t added anything important” and post something about the book (remembering to also post the purchase link, which I forget approximately 40% of the time).

There is a cost to these feelings, though, because guilt is draining. It shifts my thinking from a problem-solving one (“How can I get these ideas in front of more readers?”) to a self-critical inventory of my faults (“The book isn’t good enough. I’m not meant to be a writer. Why can’t I post pithy notes on Substack every day to make sure people know I exist?”).

Using my own guilt equation, I ask myself what expectations I’m trying to meet, and are they fair? Do my book sales actually have to be massive to view myself as a success? After all, my mom just bought 5 copies and is planning to give them to her friends as gifts (which is pretty funny. “Wow, thank you, Pat. I’d much rather have your daughter’s book about guilt than flowers or a homemade baked good.”). She clearly thinks it’s good enough to share, and aren’t we all just perpetually trying to impress our parents?

Also, am I overlooking a variety of ways I’ve shown up, worked hard, and tried to do something helpful for others? Didn’t I work on the book in my car, at my son’s dental appointment, at my gym, in my home office even though it was a beautiful, sunny day outside? Didn’t I send it to a hundred publishers and agents, accumulating a lengthy rejection list, in order to find one that would take a chance? It exists now, not because I’m a disappointment, but because I never gave up on myself.

Now, rather than letting guilt tell me I’ve done something wrong, I’m ignoring it and concentrating on my most important mission: getting the ideas in the book in front of every woman who, like me, is tired of feeling guilty. I want her to ask, “Who, exactly, is this guilt serving?” because we certainly don’t benefit from all of this guilt. Instead, it benefits those people who rely on us to do everything for everyone while they sit back and watch us work. Rather than joining together to make change in the societal and political pressures asking women to be superhuman while also systematically pushing back against our freedom and empowerment, we are turning inward and blaming ourselves for falling short.

The book is my way of saying “Enough. I’m so done with this story we’ve been fed. I want something better.” It is my firm belief that the real change will happen when women are able to ask each other, “I absolutely feel that way too, but what if it isn’t our fault?” In fact, when I’ve spoken to a roomful of women about the real reasons for all of this guilt, and reminded them they are absolutely not alone, I can see something light up on their face. I hope it’s the recognition that there is a better way, and they have the power to push back, ditch the constant concern about not doing “enough,” and begin to live with more agency and joy. That has been the best part about this whole process (well, that and my mom’s praise.)

If any of you would like to explore your guilt within your own group of amazing women, please check out my Guilt Free Groups (link on my website at jenniferreidmd.com/guilt-free-groups). I have a free host guide that will walk you through the book, and provides invitation examples, discussion questions, even rules of engagement for creating a safe space for supportive conversations. Maybe what you need most right now is not the time and energy to do more. Maybe it’s finding your own community of women who are absolutely done with constant guilt and ready for something far better.

Let’s do this, friends. We are powerful together.

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Several years ago, when Dr. Kavita Fischer downloaded an online betting app, she was just looking for something fun to do with her free time. However, within months she found herself so consumed by online gambling that she was taking out loans, chasing losses, and unable to stop, even after a big win that could have cleared her debt.

Now, she has become a leading advocate for the change in what she describes as a “predatory” industry, sharing her story of gambling disorder and relapse. As she points out, gambling disorder is among the most stigmatized of all addictions, and silence protects the industry, not the patients. In this essential episode, she and Dr. Reid discuss the conflicted interests of those who are supposed to provide regulations to the industry, the broken treatment landscape, and what real public health reform would look like.

*Please note that this episode mentions suicide and non-suicidal self-injury.

“Responsible Gambling” Is a Myth

This phrase places all blame on the individual, mirroring the tobacco and opioid playbooks. Consumer protection messaging, not personal responsibility tropes, is what’s needed. After all, responsible gambling campaigns are estimated to be up to 90% funded by the gambling industry itself, creating an obvious conflict of interest.

“It smells like, looks like something uncomfortably familiar: normalizing a product, denying the harm, blaming the user. That’s exactly what we saw with tobacco and opioids.”

-Kavita Fischer, MD

The Product Is Engineered for Addiction

Online gambling moved the casino from a destination to your pocket. Research shows proximity to a casino increases gambling disorder risk, and now everyone is living with a casino in their pocket. These apps are designed to keep you clicking and loop you back in when you try to leave. Unlike alcohol, the industry actively sends promotions and re-engagement offers to people who are trying to quit.

“No one’s leaving alcohol at your doorstep. No industry is sending coupons for alcohol to prevent you from getting treatment. That’s exactly what this industry does.”

-Kavita Fischer, MD

The Business Model Requires Addicted Gamblers

70–90% of industry profits come from problem gamblers. States that have partnered with gambling operators are essentially acting as the bookie, collecting tax revenue with little meaningful regulation protecting citizens. Additionally, this tax revenue may not be going toward the programs we expect it to.

The Highest Suicide Rate of Any Addiction

• 1 in 2 people with gambling disorder have thought about suicide

• 1 in 5 have attempted it

Per Dr. Fischer, a recent study found financial debt (not concurrent mental illness or substance use) is the single most powerful independent risk factor for suicide in this population.

The LIE/BET Screener: Two Questions That Open Doors

Only 8–10% of people with gambling disorder seek treatment on their own. Dr. Fischer advocates for universal screening using this validated two-question tool:

1. Have you ever had to lie to people important to you about how much you gambled?

2. Have you ever felt the need to bet more and more money?

Treatment Options Are Limited but Exist

There is no FDA-approved medication for gambling disorder. The gold standard is CBT + Motivational Interviewing, delivered by ICGC-certified counselors. Support groups (Gamblers Anonymous, Gam-Anon for families) and state gambling board referral lists are the most accessible entry points.

Children Are Especially Vulnerable

About 50% of adolescents have gambled in some form, mostly online. In-game mechanics like loot boxes, lucky wheels, and virtual currencies introduce gambling behavior through gaming. Dr. Fischer recommends parental controls, open conversations, and legislative pressure to enforce age restrictions.

Resources & Links

Crisis & Helplines

• National Problem Gambling Helpline: 1-800-MY-RESET (new number — crisis screening and local referrals)

• Gamblers Anonymous Hotline: 855-222-5542

Support Groups

• Gamblers Anonymous — in-person, virtual, and telephone meetings

• Gam-Anon — for family members and loved ones

Advocacy

• Stop Predatory Gambling — nonprofit exposing industry harms and pushing for policy reform

Treatment & Screening

• International Problem Gambling and Gaming Certification Organization (IPGGC) find certified CBT/MI counselors.

• LIE/BET Screener — two-question tool, appropriate for any clinical intake

Gambling-Blocking Apps

• Gamban — blocks tens of thousands of gambling sites across all devices

• BetBlocker — free, available on iOS, Android, Windows, Mac, and Linux

Dr. Fischer’s Writing

• “The Real Madness of March” — psychiatric journal article on why all clinicians should screen for gambling disorder

• The House Always Wins: Learning to Overcome Problem Gambling

• Dr. Fischer’s Substack: The Doctor and The House

Listen to Dr. Fischer on the Wall Street Journal Podcast: How a Psychiatrist Lost $400,000 on Gambling Apps

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About Dr. Kavita Fischer, MD

Dr. Kavita Fischer is a double board-certified psychiatrist in general and child & adolescent psychiatry, president of the Pennsylvania Psychiatric Society, and clinical assistant professor at the University of Pittsburgh’s Department of Psychiatry. She works as an emergency room psychiatrist and is a national speaker advocating against the harms of commercialized gambling, drawing on her own lived experience with gambling disorder and recovery.

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A Mind of Her Own

Hosted by Dr. Jennifer Reid, MD

Board-certified psychiatrist, author of Guilt Free: Reclaiming Your Life From Unreasonable Expectations, and award-winning medical educator

jenniferreidmd.com | A Mind of Her Own on Substack

@jenreidmd on Instagram and LinkedIn

Also check out Dr. Reid’s regular contributions to Psychology Today: Think Like a Shrink

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255
Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:
The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

— Dr. Allison Daminger

If you’ve ever lain awake mentally running through tomorrow’s logistics while your partner sleeps soundly beside you, this episode is for you. Dr. Allison Daminger, sociologist and author of What’s on Her Mind?, has spent nearly a decade studying something most families feel but few can name: the invisible cognitive labor that keeps a household running. It’s not the cooking or the carpooling, it’s the anticipating, the researching, the deciding, and the endless following up.

In this conversation, Dr. Daminger unpacks why this mental work falls so disproportionately on women—even in couples who are genuinely trying for something more equal, what makes it so stubbornly hard to redistribute, and what it would actually take, in our homes and in our culture, to change it.

Website: allisondaminger.com · Substack: The Daminger Dispatch

What Is Mental Workload?

Dr. Daminger describes mental workload as “project management for the household” — a set of cognitive processes geared toward figuring out what a family needs and ensuring those needs get fulfilled. It breaks down into four key steps:

1. Anticipation — scanning ahead for upcoming needs, problems, or opportunities

2. Identifying options — brainstorming or researching possible solutions

3. Decision-making — choosing the best course of action for the family

4. Monitoring — following up to make sure the solution actually worked

Unlike physical housework, this labor is largely invisible, often not recognized as “work” even by the person doing it.

“This is a set of mental processes that are geared toward figuring out what your family needs, what you owe to other people, and then how to ensure that those needs and obligations get fulfilled.”

— Dr. Allison Daminger

Key Research Findings

The Gender Gap Is Stark

In Dr. Daminger’s study of different-gender couples, 4 out of 5 were “woman-led,” meaning she was effectively the “cognitive laborer in chief.” While couples were closer to 50-50 on physical housework (cooking, cleaning, driving), the mental work remained deeply unequal.

Earning More Doesn’t Level the Playing Field, Not for Women

When men earned more or worked more hours, they almost always did less cognitive labor. But the same did not hold true in reverse: women who were the primary earners still shouldered a disproportionate share of mental work. The breadwinner pass applied to men, not women.

“In cases where she was doing more hours or earning more money, a lot of the time she was still doing more of the cognitive labor.”

— Dr. Allison Daminger

Why Does This Persist?

Accountability Structures

One of Dr. Daminger’s core explanations is “accountability structures,” which is the fact that men and women are held responsible for different outcomes. Men feel guilt around financial failure; women feel guilt when household or parenting management slips. This asymmetry shapes who pays attention and who steps in.

“If the kid comes to school missing their clarinet on band day, or guests come over and there’s dog hair on the floor, these are outcomes that usually are going to be blamed on women.”

— Dr. Allison Daminger

The Stickiness Problem

Cognitive labor is deeply embedded in knowledge, relationships, and practice, making it hard to hand off. A partner who has attended every pediatrician appointment holds context the other doesn’t have. Many women conclude it’s simply easier to keep doing it than to train someone else. This keeps the division of labor frozen even when both partners want change.

“You can teach someone to change a diaper pretty quickly. But a lot of cognitive work is embedded in knowledge and relationships that are hard to just hand over.”

— Dr. Allison Daminger

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What Balanced Couples Do Differently

“If you can lead from the place of: I’m suffering, this is not working for me, that will activate a form of compassion that is harder to access when it’s framed as criticism.”

— Dr. Allison Daminger

Transfer Ownership, Not Just Tasks

The “just tell me what to do” dynamic is a common trap. If she’s still the one generating the list, she still owns the domain. Dr. Daminger’s advice: transfer full vertical ownership of a category, not just execution of individual tasks.

“All things laundry, that’s now you. Not just one piece, but making sure there’s detergent, making sure the kids have clean clothes on time, making sure the washer and dryer are functioning. If you can give someone up-and-down vertical ownership of the whole project, that’s often more effective than one-off task delegations.”

— Dr. Allison Daminger

Start Small and Give It Time

• Pick lower-stakes domains first — tasks you won’t catastrophize if done differently

• Set a grace period (e.g., two weeks) before evaluating — transitions are inherently bumpy

• Avoid overhauling everything at once; there will be mistakes as skills are built

• Resist the urge to take back a task the moment it’s done differently than you would

Key Takeaway

The skills that shape who does cognitive labor are learned, not innate. Calling it a “personality difference” lets the pattern off the hook. Dr. Daminger’s research suggests that recognizing the work, naming it, and deliberately redistributing ownership (not just tasks) is how couples begin to change. The structure matters too: fewer systemic barriers mean fewer forced tradeoffs, and a more level playing field at home.

Listen to the full episode to hear what she suggests for more broad, societal level changes that could help this imbalance of cognitive load.

Subscribe now

A Mind of Her Own

Hosted by Dr. Jennifer Reid, MD

Board-certified psychiatrist, author of Guilt Free: Reclaiming Your Life From Unreasonable Expectations, and award-winning medical educator

jenniferreidmd.com | A Mind of Her Own on Substack

@jenreidmd on Instagram and LinkedIn

Also check out Dr. Reid’s regular contributions to Psychology Today: Think Like a Shrink

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255
Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:
The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

Episode Overview

In this episode, host Dr. Jennifer Reid sits down with Dr. Cory Newman, PhD to explore how the core principles of cognitive behavioral therapy can be woven into our everyday communication with partners, friends, family, coworkers, and even ourselves. What begins as a conversation about therapy technique quickly becomes a practical guide to navigating disagreements, setting boundaries, and showing up more compassionately in all our relationships.

Throughout the conversation, Dr. Reid draws connections to her book Guilt Free: Reclaiming Your Life from Unreasonable Expectations (Penguin Life, 2026), which examines how guilt—particularly for women—shapes our communication patterns, our willingness to set boundaries, and our capacity for self-compassion.

15 Key Takeaways

(Dr. Newman had so many life-changing recommendations, we wanted to make sure you could read about them even if you didn’t have time to listen!)

1. The Three Pillars of CBT

Dr. Newman describes CBT as resting on three foundational principles:

1. A supportive therapeutic alliance

2. A deep understanding of the patient’s lived experience (including cultural and sociological factors)

3. The development of practical coping skills. These skills promote agency and problem-solving rather than hopelessness and helplessness.

CBT Connection: The cognitive behavioral model emphasizes that thoughts, behaviors, and emotions are interconnected. By shifting how we think and what we do, we can change how we feel (Beck, 1979).

2. Communication Is Both Internal and External

We tend to think of communication as what we say to others, but Dr. Newman emphasizes that internal dialogue matters just as much. CBT helps people talk to themselves more compassionately, constructively, and hopefully. That same skill then translates outward into better interpersonal communication.

He also distinguishes between expressive communication (how we speak) and receptive communication (how we listen), both of which are essential to healthy relationships.

Guilt Free Connection: In Guilt Free, Dr. Reid explores how harsh internal dialogue, especially the relentless voice of “I should be doing more,” fuels excessive guilt. Learning to communicate with yourself compassionately is the first step toward breaking free from unreasonable expectations.

3. Start with Intent

Every meaningful conversation benefits from a clear, positive intent: to boost morale, to connect, to offer something useful, to communicate understanding. Dr. Newman suggests that even outside of therapy, we can adopt the mindset that our goal in any interaction is to leave the other person, and the relationship, in a better state than when we started.

CBT Connection: Intentional communication is a behavioral intervention. By deliberately choosing our communicative goals before speaking, we interrupt automatic patterns that often lead to conflict (Beck, 1995).

4. Validity + Utility: The Two-Part Test for What We Say

Dr. Newman introduces a powerful filter: before speaking, ask whether your comment has both validity (is it truthful?) and utility (is it useful?). Truth alone can be harsh. He pushes back on the idea of “brutal honesty.”

Guilt Free Connection: The validity-utility framework directly parallels the guilt equation in Guilt Free, where guilt = our expectations (whether fair or not) minus our perceived reality. Often, guilt-driven communication passes the validity test but fails the utility test. For example, we may say things out of obligation that don’t help ourselves or others.

5. Intent vs. Impact: Naming the Mismatch

Sometimes people don’t mean to cause harm, but their words land that way. Dr. Newman recommends naming the gap directly: “I don’t think you’re trying to put me down, but the message you’re sending sounds like a put-down.” This approach acknowledges the other person’s good faith while still making room for your experience.

CBT Connection: Distinguishing between intent and impact is central to cognitive restructuring. Cognitive distortions like mind-reading and personalization often cause us to assume malicious intent where there is none (Burns, 1980).

6. Seek to Understand Before Problem-Solving

When someone is in distress, the instinct is often to jump straight to fixing. Dr. Newman advises leading with empathy instead: “If I were thinking the way you’re describing, I’d be a nervous wreck too.” Validate first, then gently offer alternative perspectives. Problem-solving is more effective once the person feels heard.

Guilt Free Connection: Dr. Reid describes a pattern she sees frequently, which is people, especially women, catastrophizing about situations and layering guilt on top. The compassionate validation Dr. Newman describes is exactly the antidote: honor the feeling, question the expectation.

7. Turn Complaints into Requests

Almost any complaint can be reframed as a request, and requests are far easier to hear. Instead of “You never reply to my voicemail messages,” try: “I’d really appreciate hearing from you, even briefly. It’s hard for me when I don’t hear from you.”

CBT Connection: This reframing technique is a classic behavioral strategy in CBT. Converting complaints into constructive requests shifts the dynamic from blame to collaboration (Gottman & Silver, 1999).

Guilt Free Connection: Dr. Reid explores how maladaptive guilt can be manipulative, such as when guilt-tripping replaces genuine requests, and relationships can suffer. Assertive communication (making requests without guilting) is key to breaking that cycle.

8. Silence Fills Vacuums with Assumptions

When we avoid communication to spare someone’s feelings—say, not RSVPing to avoid disappointing a friend—we leave a vacuum that the other person fills with their own assumptions, which are usually worse than reality. Dr. Newman advises speaking the reality, even when it’s uncomfortable, because silence invites personalization and catastrophizing.

Guilt Free Connection: In Guilt Free, Dr. Reid identifies avoidance as a common guilt-driven behavior: we don’t say no because we don’t want to disappoint, but the silence itself creates a bigger problem. Communicating honestly, even imperfectly, is almost always better than disappearing.

9. Beware All-or-Nothing Thinking in Communication

Dr. Newman applies one of CBT’s most foundational concepts, challenging black-and-white thinking, to our communication habits. You don’t have to choose between long silences and a 90-minute heart-to-heart. A quick text saying “Thinking of you” is a powerful middle ground. He calls these “random acts of kindness through text,” which are small gestures that send a meta-message of care.

CBT Connection: All-or-nothing thinking is one of the most common cognitive distortions identified in CBT. Recognizing and challenging it opens up a range of behavioral options we might not have considered (Beck, 1976).

10. Match the Medium to the Message

Text messaging is ideal for quick logistics and small kindnesses, but it strips away tone of voice and body language. Dr. Newman shares a vivid example of a patient whose text “I don’t care” (meaning “I don’t mind”) sparked a major argument with his girlfriend. For emotional or complicated conversations, choose a medium with more cues, such as phone, video, or in person.

His rule of thumb: The more emotional and the more complicated the topic, the more cues are needed.

11. The Gottman 20-Minute Rule

Drawing on research by John and Julie Gottman, Dr. Newman describes how physiological arousal (elevated heart rate, fight-or-flight activation) makes productive conversation impossible. The Gottmans recommend taking a break during heated arguments and not resuming until at least 20 minutes after your heart rate returns to baseline.

Dr. Newman applies this to everyday life: if you receive a message that makes you angry, wait until you’ve calmed down before responding. Otherwise, frustration will leak through even your most careful words.

CBT Connection: Self-monitoring of physiological arousal is a core CBT skill. The Gottman research demonstrates that behavioral interventions (taking a break) must precede cognitive interventions (discussing the issue) when the body is in a threat state.

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12. Resolve to Resolve—Not to Win

Dr. Newman highlights one of the most destructive communication patterns: trying to win an argument rather than resolve it. He references the devastating scene in the film Marriage Story where two characters escalate insults in an attempt to out-hurt each other. When the goal shifts from understanding to victory, everyone loses.

CBT Connection: The belief “I must convince the other person I’m right” is a cognitive distortion that fuels conflict. CBT teaches that making your point respectfully is already a success. Change in the other person may come later, or not at all, and that’s okay (Newman, 2014).

13. Never Go to Bed Angry? Not So Fast.

Both Dr. Reid and Dr. Newman agree that while the spirit of this advice is sound (don’t harbor resentment) the literal application can be harmful. Insisting on resolving a conflict when one partner is exhausted is destructive. The person who needs to sleep should be honored. The meta-message is: don’t stonewall, but do respect each other’s limits. Use a placeholder: “I want to talk this through, but right now I can’t yet.”

Guilt Free Connection: This scenario is a guilt trap in action. The pressure to resolve everything immediately often comes from guilt (“A good partner wouldn’t go to bed angry”). Dr. Reid’s framework encourages questioning whether that expectation is fair and giving yourself permission to rest.

14. Setting Boundaries Without Guilt

When repeated attempts at respectful communication are met with resistance, such as the same pressure, the same guilt trips, it’s appropriate to set a firm boundary. Dr. Newman advises doing so with care: “I’d like to talk to you, but not under these conditions. When you can show some respect for what I’ve said, let me know.” You can walk away from that interaction knowing you handled it with integrity.

Guilt Free Connection: Dr. Reid identifies “hyper-accountability,”the belief that we can and should control other people’s emotional experience, as a major driver of excessive guilt, especially for women. Letting go of the need to make everyone feel okay is essential to healthy boundary-setting.

15. Say the Positive Things Out Loud

Dr. Newman closes with a deceptively simple but powerful reminder: don’t keep positive thoughts to yourself. If you have a compliment, give it. If you feel affection, express it. And one of his favorite tips: talk positively about people behind their back. It often gets back to them and can shift the entire tone of your relationships.

CBT Connection: Behavioral activation, which involves increasing positive interactions and reinforcement, is a foundational CBT technique for improving mood and strengthening relationships (Lewinsohn, 1974).

About the Guest

Dr. Cory Newman, PhD is a professor of psychology in psychiatry and director of the Center for Cognitive Therapy at the University of Pennsylvania. He is also honorary faculty at the Beck Institute for Cognitive Behavioral Therapy, where he completed his postdoctoral training under the mentorship of Dr. Aaron Beck, a founding father of CBT. A founding fellow of the Academy of Cognitive Therapy, Dr. Newman has presented approximately 300 CBT workshops and seminars internationally and published over 100 articles and chapters. He is the author or co-author of six books. Fun connection: Dr. Newman is a highly accomplished pianist and has accompanied Dr. Reid for several of her vocal performances.

References & Further Reading

CBT Foundations

1. Beck, A. T. (1976). Cognitive Therapy and the Emotional Disorders. International Universities Press.

2. Beck, J. S. (1995). Cognitive Behavior Therapy: Basics and Beyond. Guilford Press.

3. Burns, D. D. (1980). Feeling Good: The New Mood Therapy. William Morrow.

Communication & Relationships

4. Gottman, J. M. & Silver, N. (1999). The Seven Principles for Making Marriage Work. Crown.

From the Guest

6. Newman, C. F. (2014). Core Competencies in Cognitive-Behavioral Therapy. Routledge.

From the Host

7. Reid, J. (2026). Guilt Free: Reclaiming Your Life from Unreasonable Expectations. Penguin Life.

(*Notes created from transcript with assistance from Claude AI and edited by author for clarity and accuracy.)

A Mind of Her Own

Hosted by Dr. Jennifer Reid, MD

Board-certified psychiatrist, author, and award-winning medical educator

jenniferreidmd.com | A Mind of Her Own on Substack

@jenreidmd on Instagram and LinkedIn

Also check out Dr. Reid’s regular contributions to Psychology Today: Think Like a Shrink

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255
Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:
The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

I want to share an upcoming conversation that feels both timely and deeply personal for me — especially for those of us in healthcare who are also parents, caregivers, or simply people who carry a lot.

I’ll be in conversation with two physician-parents, Dr. Nima Brown and Dr. Megan Kamath, hosted by Introspective Spaces, reflecting on how caretaker guilt shows up in real life — in our work, our homes, and our inner worlds.

Always On Call: Caretaker Guilt in Parenting and Practice
Thursday, February 12 at 11:00 AM PST
Virtual & free
Register here: https://www.introspectivespaces.com/alwaysoncall

Healthcare work has a way of keeping us perpetually “on call” — not just clinically, but emotionally. Many of us carry persistent guilt: guilt toward patients, guilt toward our families, guilt toward ourselves. This gathering creates space to name that experience honestly and explore what it might look like to relate to guilt with more compassion and less self-punishment.

In addition to shared reflection, we’ll offer practical, usable takeaways — ways to work with guilt that participants can bring into both their professional and personal lives right away.

This event may resonate especially if you:

• work in healthcare and feel stretched between care at work and care at home

• are navigating moral distress, burnout, or chronic “never enough” feelings

• want language, tools, and community around experiences we don’t talk about enough

There’s no cost to attend — just an invitation to pause, reflect, and be in conversation with others who understand the terrain.

I hope you’ll join us, and I’d be grateful if you shared this with anyone who might benefit.

Warmly,
Jennifer

Thanks for reading A Mind of Her Own! Subscribe for free to receive new posts and support my work.

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We dive into the identity crisis that often comes with infertility, what to expect from those first medical appointments, and how to be kind to yourself through the process. Dr. Smotrich shares practical advice on setting boundaries with friends and family, managing the emotional roller coaster of hope and disappointment, and finding safe people to talk to. Throughout it all, Dr. Smotrich reminds us that seeking help is actually a sign of strength.

*Please note: we briefly discuss pregnancy loss and miscarriage.

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Resources Mentioned:

• Postpartum Support International (PSI) - Offers support groups, virtual meetings, and peer mentor programs for fertility challenges, pregnancy loss, and perinatal mental health

• Penn Fertility Care in Philadelphia and surrounding areas

Connect with Dr. Smotrich:

Licensed in New Jersey, Pennsylvania, and 45+ states via SciPact for telehealth services. Visit her website for more information.

https://keri-smotrichpsyd.clientsecure.me/

Remember: Seeking support is a sign of strength, not weakness. You don’t have to white knuckle through this journey alone.

Find Dr. Reid on Instagram: @jenreidmd, LinkedIn, and YouTube

You can also order Dr. Reid’s book, Guilt Free! (If you are in the UK, you can order here and here.)

Also check out Dr. Reid’s regular contributions to Psychology Today: Think Like a Shrink

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255
Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:
The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

Since Tuesday, I’ve travelled to NYC to join Zibby Owens for a live recording of her podcast, Totally Booked with Zibby, which was a blast. Receiving questions from the audience brings the book to life in such a powerful way, and I’m honored by their interest.

I’m also thrilled to share that Guilt Free was featured in the New York Times Well newsletter!

I’m so grateful to the Times and journalist Jancee Dunn for highlighting the book, and I hope readers will feel empowered to move beyond unhelpful guilt toward something far more joyful.

Later today, I will pack up my winter emergency kit (coffee, a blanket, full tank of gas, and a great playlist), and drive into Philadelphia to speak with Marty Moss-Coane on The Connection at the WHYY studios. This all feels like a dream.

Thank you to those who have reached out with congratulations and well-wishes. They mean the world to me. If you have had a chance to read Guilt Free, or do so in the future, please let me know what you think. The book was shaped by my interactions with amazing women around the country, and I want to keep hearing your stories and experiences.

Stay warm, friends, and remember, you are already enough.

Subscribe now

This book has been several years in the making, inspired by my work as a psychiatrist and teacher, where I was hearing so many people, especially women, describe a feeling of constant guilt. “I should be doing more.” “I’m not getting anything right.” “I feel like the absolute worst mother, friend, partner...etc.” This book sets out to help understand why we feel so much guilt, and how to begin to weaken its hold.

I’ve included the most effective strategies I use in therapy sessions, including techniques from interpersonal therapy, positive psychology, self-compassion, CBT and growth mindset work, as well as my framework, SPEAK, to describe the key steps in the change process of psychotherapy.

I’ve been honored to have the book chosen as a January must-read for The Next Big Idea Club, a list of the best new nonfiction as curated by Adam Grant, Malcolm Gladwell, Susan Cain and Daniel Pink. The book will also be featured on WHYY’s The Connection with Marty Moss-Coane and the New York Times “Well” newsletter with Jancee Dunn.

If you have any interest in helping me spread the word, please feel free to share this post.

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We discuss:

• External validation (fellowships, book deals) helps but isn’t the whole story—self-actualization with age matters more

On Midlife Transformation

• The conversation centered on women making big changes in midlife when life seems “set”

• Mara just turned 40 and sees a shift toward self-actualization that comes with age

• There’s power in coming to realize what doesn’t work for you (as Jennifer noted from Parker Palmer) as much as what does

On Healthcare and Creativity

• Both physicians emphasized the need for creative outlets alongside science—whether theater, writing, or podcasting

• The medical system rewards quantitative efficiency over storytelling, yet healthcare contains rich narratives that deserve to be told

• Writing in healthcare comes with unique fears: professionalism concerns, employer reactions, HIPAA violations, plus universal impostor syndrome

Advice for Healthcare Writers

1. Write beyond fear: Identify specific sources of fear (HIPAA, professional image, employer concerns) and name them

2. Find your values: What matters to you? Build work that lets you grow and shine in alignment with those values

3. Build community: Connect with other writers, mentors, and trusted friends who can help you navigate fears

4. Try different formats: Podcasts, newsletters, books—find what feels authentic to your communication style

Notable Quote: “I think anyone in healthcare has really the potential to create some beautiful work. There’s so many stories there that really deserve to be told.”

The Takeaway: Writing is an act of courage, especially in fields like medicine where vulnerability feels risky. But midlife offers a gift—enough experience to know what matters, enough confidence to claim your voice, and enough wisdom to write beyond fear.

Find Dr. Reid on Instagram: @jenreidmd, LinkedIn, and YouTube

You can also preorder Dr. Reid’s book, Guilt Free! (If you are in the UK, you can order here and here.)

Also check out Dr. Reid’s regular contributions to Psychology Today: Think Like a Shrink

Share

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255
Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:
The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.

Get more from Jennifer Reid, MD in the Substack app

Available for iOS and Android

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Today is an exciting day, because we are just one week from publication for my book, Guilt Free! This book has been years in the making, not just writing and editing it (with a terrific team at Penguin Life and The Book Group) but also all of the sessions with patients over more than a decade of work as a psychiatrist and teacher.

When you have the opportunity to sit across from thousands of women as they share their joys and sorrows, their challenges and triumphs, you begin to see patterns emerge in their words. One of these patterns I kept noticing was the painful experience of constant guilt. “I just never feel like I’m doing enough.”

This book, then, began as a way for me to research and deeply consider the roots of our persistent, draining guilt, and to share all of the time-tested, evidence-based strategies I knew to help make a major change in women's lives.

On a personal level, writing and editing this book has been a powerful path to less guilt in my own life. As a busy working mother, a wife, daughter, friend, sister and colleague, I was putting so much pressure on myself to take care of EVERYONE, even at my own expense. I was trying to manage other people’s feelings (impossible!) and believing I needed to be perfect, and perfectly productive, to be valuable.

Guilt Free helped me see that I was placing incredibly unfair expectations on myself, and consistently minimizing the ways I was showing up, giving to others, and making a difference in the world around me. My deepest hope is that this book can do the same for you.

So, friends, let’s start a conversation about guilt. Why has it become so ubiquitous in women’s lives, and how can we begin to fight back?

This book begins that journey, and I know you all have the strength and courage to just keep going. We deserve to live guilt free.

Are you in the Philadelphia area? If so, please join me for the book launch 7pm Tuesday, January 27th at Inkwood Books in Haddonfield, NJ. I will be in conversation with the wonderful writer (and a dear friend), . See you there!

Anu Gorakanti (MD) and Laura Holford (RN) co-founded Introspective Spaces, a collective creating contemplative community spaces for healthcare workers to reconnect with themselves and reimagine a new way forward in healthcare. Now approaching their five-year anniversary, they share how they’re building “small communities of care” across the country—one relationship at a time.

on Substack

Listen to a prior podcast with Anu and Laura here!

Key Themes:

• The Power of Slow Work: “Change moves at the speed of trust” (Stephen Covey, via adrienne maree brown’s Emergent Strategy). Building authentic community takes time, and that’s exactly what healthcare needs.

• From Isolation to Connection: Both founders started Introspective Spaces after feeling alone in their moral distress, believing they were the only ones struggling. Their mission: help healthcare workers realize they’re not alone.

• The Imagination Battle: As adrienne maree brown writes, we’re living in someone else’s imagination. Healthcare’s current design is intentional—but healthcare workers can activate their own imagination to create something different.

• Humanizing One Another: “What if humanizing healthcare starts with humanizing one another?” Breaking down silos between physicians, nurses, and other healthcare workers can shift the entire culture of care.

Introspective Spaces Programs:

• Artist’s Way cohorts (including a new healthcare parents group) Next cohort begins March 9th!! Sign up here.

• Grief spaces and retreats

• Book clubs using foundational texts like Emergent Strategy

• Building interdisciplinary communities in 5-6 cities nationwide

• Find them in Instagram @IntrospectiveSpaces

Other Resources Mentioned:

• Emergent Strategy by adrienne maree brown

• The Artist’s Way program, based on the book by Julia Cameron

• Let Your Life Speak by Parker Palmer (Listen to Dr. Reid’s interview with Dr. Palmer here!)

• The Pitt (Max series depicting healthcare moments rarely seen in real life)

Find Dr. Reid on Instagram: @jenreidmd, LinkedIn, and YouTube

You can also preorder Dr. Reid’s book, Guilt Free! (If you are in the UK, you can order here and here.)

Also check out Dr. Reid’s regular contributions to Psychology Today: Think Like a Shrink

Seeking a mental health provider? Try Psychology Today

National Suicide Prevention Lifeline: 1-800-273-8255
Dial 988 for mental health crisis support

SAMHSA’s National Helpline - 1-800-662-HELP (4357)
-a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.

Disclaimer:
The views expressed on this podcast reflect those of the host and guests, and are not associated with any organization or academic site. Also, AI may have been used to create the transcript and notes, based only on the specific discussion of the host and guest and reviewed for accuracy.

The information and other content provided on this podcast or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this website, blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services (911) immediately. You can also access the National Suicide Help Line at 1-800-273-8255 or call 988 for mental health emergencies.