Couples and Sex Therapy: Myths and Truths (Part 1)
In this episode, we sat down with Dr. Nikki Haddad—Margaret's residency best friend, couples and sex therapist, and one of the most thoughtful psychiatrists I know—to break down what makes romantic relationships so damn hard. We get into myths we’ve carried (and tried to shake), how sexual issues are rarely just about sex, and why our training in medicine doesn’t prepare us to talk about any of this. Nikki then walks us through the five developmental stages of a relationship and this is only Part 1. Be sure to stay tuned next week for Part 2 of the conversation!
Takeaways:
I used to think the right relationship should feel easy. Turns out, the real ones take work, discomfort, and occasionally arguing over ice cream.
Nikki taught us that sex issues aren’t just about the act—they’re a doorway to everything else we avoid.
I finally learned what “differentiation” means in a relationship—and why it feels like breaking up with your past self.
Couples therapy isn’t just two people yelling about chores. It’s a roadmap, a mirror, and a lot of basketball metaphors.
Yes, Margaret and I roleplayed a fictional couple. Yes, I did an accent. No, we will not be taking questions.
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Want more Dr. Nikki Haddad:
IG: @nikkiiiirose
Watch on YouTube: @itspresro
Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc.
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Produced by Dr Glaucomflecken & Human Content
Get in Touch: howtobepatientpod.com
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1:03:26
Q&A from YOUR listener submissions
We opened up the inbox and wow… y’all really came through. In this first-ever Q&A episode, Margaret and I answer your questions about coping during med school, surviving feedback, dealing with emotional exhaustion in residency, and why outpatient goodbyes feel like actual breakups. I also overshare about marathon training (again), Margaret brings the wisdom and the theater metaphors, and we all learn what bald eagles actually sound like. It’s a mix of serious, strange, and unexpectedly honest—basically, peak us.
Takeaways:
What if taking feedback wasn’t about defending yourself—but just... listening? It took me a while to get there. Still working on it.
Graduating patients from therapy might be the hardest part of residency. Margaret gets into what that really feels like.
Coping doesn’t always look like wellness. Sometimes it looks like boundary-setting, running way too far, or just... wearing real pants again.
The match will mess with your head. But six months into residency? You’ll probably be right where you need to be.
Can we measure healing in showers taken, not symptoms cured? Asking for a friend. And all of psychiatry.
Watch on YouTube: @itspresro
Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc.
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Produced by Dr Glaucomflecken & Human Content
Get in Touch: howtobepatientpod.com
Learn more about your ad choices. Visit megaphone.fm/adchoices
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56:44
Is Trauma Stuck in My Hips?
This week, I learned I have a pelvic floor. And yes, I realize I’m a doctor and should’ve known that already. Margaret and I talk with pelvic floor physical therapist and viral educator Dr. Alicia Jeffrey-Thomas, who somehow made me breathe through my butt on mic. We cover everything from incontinence and pelvic pain to TikTok fame, trauma-informed care, and the surprisingly emotional world of core stability. Alicia breaks down the science and the stigma behind one of the most misunderstood parts of the body—and I try to keep up while sitting on a pillow and trying not to Kegel too hard.
Takeaways:
I didn’t know I had a pelvic floor until this episode. Spoiler: everyone has one. Yes, even you.
Turns out, anxiety might live in your hips. Alicia explains how mental health and physical tension are way more connected than I realized.
We talk about peeing “just in case” more than I ever expected to on this podcast. And it’s weirdly important.
Margaret brought the neuroscience, Alicia brought the pelvic models, and I brought... confusion and curiosity. It actually worked.
If you’ve ever felt disconnected from your body, this one’s for you. And if you haven’t—congrats on being a floating brain, I guess.
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Want more Dr. Alicia Jeffrey-Thomas:
IG / TT: @thepelvicdancefloor
Website: http://www.thepelvicdancefloor.com
Watch on YouTube: @itspresro
Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc.
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Produced by Dr Glaucomflecken & Human Content
Get in Touch: howtobepatientpod.com
Learn more about your ad choices. Visit megaphone.fm/adchoices
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1:17:09
Trying to Meditate: Part II
In the last episode, Preston demonstrated to Margaret how to properly conduct a mindfulness meditation session. Due to popular demand, the sage spiritual guide is back.
Takeaways:
Preston can’t lead a meditation
Margaret shouldn’t let him try
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Watch on YouTube: @itspresro
Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc.
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Produced by Dr Glaucomflecken & Human Content
Get in Touch: howtobepatientpod.com
Music: “Peaceful, Reiki, Meditation, Calm, Healing Music [ NO COPYRIGHT ]” by Moon Meditation Music // License: Creative Commons Attribution License
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4:35
Our Favorite Coping Skills for Working in Stressful Times
In Episode 16, Preston and Margaret dive into the chaos of overnight residency, the reality of sleep deprivation, and how mindfulness can backfire when your brain just won’t sit still. From ruined meditations to hot girl walks through hospital hallways, they unpack what real-world coping actually looks like—before, during, and after the hardest moments.
Takeaways:
Coping doesn’t always look like calm. Sometimes it looks like sour gummy worms, a midnight hospital lap, or an espresso ritual that holds your brain together.
Mindfulness is hard—especially when you need it most. Preston and Margaret explore why stillness can feel unbearable and what that reveals.
The ‘right’ tool at the wrong time can make things worse. They break down when distraction works, when it doesn’t, and why guilt shouldn’t be part of the equation.
Safety plans might be broken. What happens when you’re just checking boxes—and how can we make them matter again?
Sometimes the coping skill is just surviving. This episode redefines success as doing what you can with what you’ve got, even if it's messy.
Watch on YouTube: @itspresro
Listen Anywhere You Podcast: Apple, Spotify, PodChaser, etc.
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Produced by Dr Glaucomflecken & Human Content
Get in Touch: howtobepatientpod.com
Learn more about your ad choices. Visit megaphone.fm/adchoices
You may have noticed a new trend lately. Everyone is loud and proud about their mental health struggles (and thank goodness)! For practitioners, this movement is as exciting as it is frustrating. As each mental health taboo falls by the wayside as it enters the cultural zeitgeist, a new aspect of our specialty thus emerges. One we just don’t have enough hours in the day to keep track of, let alone engage with. From better understanding our patients’ (and our own) relationships with their conditions in a changing world, it’s more important than ever that we learn: HOW TO BE PATIENT!
Each week, join Dr. Preston Roche (Psychiatry Resident & Digital Influencer) and Dr. Margaret Duncan (Psychiatrist & Content Creator) on their quest to better understand the patients we dedicate our lives to and the evolving paths they’re bound to travel beyond the clinic. By engaging with stories and perspectives that challenge our shared understanding of a condition, we hope you’ll similarly gain new perspectives as we look at our patients, and their mental health struggles, with further nuance and empathy. (And with Dr. & Lady Glaucomflecken producing, we've been mandated to include plenty of weird medical jokes too).
Speaking of which, a key part of this is hearing YOUR stories! What’s changed your understanding of patient care? Do you have an experience that shines new light on something we’ve discussed on-air? Get in touch at: howtobepatientpod.com
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