Mind Dive, A Podcast for Mental Health Professionals

Psychosis is often treated like a medical emergency that must be “stabilized” before anyone can think with the person, but that stance can quietly teach patients that their inner life is not worth understanding. We talk with psychiatrist and author Dr. Michael Garrett, a pioneer in psychotherapy for psychosis, about how to listen for meaning inside hallucinations, delusions, and disorganized speech without rushing to flatten everything into a checklist of symptoms. Our north star is the idea that psychotic experience sits on a continuum with ordinary mental life, and that patients are often trying to communicate grief, fear, and conflict in the only way that feels available.

We dig into how Dr. Garrett integrates CBT for psychosis with psychodynamic thinking. Instead of starting with a bold interpretation, he begins with the patient’s conscious experience and the “evidentiary chain” that led them to a belief: what they perceived, how they made sense of it, and what conclusions felt unavoidable. Along the way, we explore why metaphor can break during active psychosis, turning “this feels like danger” into “this is danger,” and what that implies for clinical stance, empathy, and therapeutic pacing.

We also wrestle with big system questions that shape real care: why training programs rarely teach psychotherapy for schizophrenia, what it takes to build services in public psychiatry, and how clinicians can think about triage without giving up on people. Dr. Garrett makes a compelling trauma-informed case for viewing many psychotic presentations as a complex PTSD phenotype shaped by biology, while still recognizing the lifesaving role of antipsychotic medication when symptoms demand it.  More ion this topic can be found in his book: Psychotherapy for Psychosis, Integrating Cognitive Behavioral and Psychodynamic Treatment.

If you care about schizophrenia treatment, trauma and psychosis, CBTp, psychodynamic therapy, or building humane mental health systems, this conversation is for you. Subscribe, share this with a colleague or friend, and leave a review with your biggest takeaway.

Subscribe, share this with a colleague or friend who cares about the future of mental health care, and leave a review with your biggest takeaway.