Challenging how we think about extreme mental states and the institutions that claim to treat them. Essays, conversations, and more from Dr. Michael R. Montgomery, international Existential Psychoanalyst. <br/><br/><a href="https://psychophobia.substack.com?utm_medium=podcast">psychophobia.substack.com</a>
psychophobia* podcast
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Challenging how we think about extreme mental states and the institutions that claim to treat them. Essays, conversations, and more from Dr. Michael R. Montgomery, international Existential Psychoanalyst. <br/><br/><a href="https://psychophobia.substack.com?utm_medium=podcast">psychophobia.substack.com</a>
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3/31/2026
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Recent Episodes
June 16, 2026
Episode 09: Part II - When Treatment Becomes the Problem - How modern psychiatry lost the human being
<p><strong>“Hope is not the conviction</strong> that something will turn out well, but the certainty that something makes sense regardless of how it turns out.” — Václav Havel</p><p>— —</p><p><strong>Stevie Nicks lost her creativity</strong>, her zest for life, and her body to a benzodiazepine cocktail prescribed by a psychiatrist she trusted. A friend who tried the same regimen was on his back by evening. It took three months in a clinic to detox - and her life came back. Stories like hers are the ground Michael and Robert Whitaker walk in the second half of their conversation, alongside Tony Stanton’s residential center for the “worst of the worst” kids who “came alive again” once the medications stopped, and the polypharmacy patterns that, as Bob puts it, have “zero, zip” evidence behind them. From there the conversation widens into what Mad in America has built, the alternatives operating at scale in Norway and Israel, and a philosophy of care that fits on a notecard: how can I be of help to you? If recovery and hope have somehow become the conspiracy theories of modern psychiatric culture, perhaps the revolution is simpler than a new model of care.</p><p>— —</p><p>“<strong>When did recovery and hope become conspiracy theories?</strong>“ — Dr. Michael R. Montgomery</p><p>— —</p><p><strong>Follow us</strong></p><p><a target="_blank" href="https://psychophobia.com/">psychophobia.com</a> |<a target="_blank" href="https://psychophobia.substack.com/"> Substack</a> |<a target="_blank" href="https://www.linkedin.com/in/drmontgomery23/"> LinkedIn</a> |<a target="_blank" href="https://instagram.com/psychophobia_project"> Instagram</a> |<a target="_blank" href="https://www.youtube.com/@psychophobia_project"> Youtube</a></p><p>Send us a message:<a target="_blank" href="https://www.speakpipe.com/psychophobia"> https://www.speakpipe.com/psychophobia</a></p><p><strong>Follow Bob</strong></p><p><a target="_blank" href="https://www.madinamerica.com/">Mad In America</a></p><p>Books</p><p><a target="_blank" href="https://www.madinamerica.com/mad-america-book/">Mad In America</a> | <a target="_blank" href="https://www.madinamerica.com/anatomy-of-an-epidemic-2/">Anatomy of an Epidemic</a> | <a target="_blank" href="https://www.madinamerica.com/psychiatry-under-the-influence/">Psychiatry Under the Influence</a></p><p>— —</p><p><strong>Robert Whitaker is an American journalist</strong> and author who has won numerous awards as a journalist covering medicine and science, including the George Polk Award for Medical Writing and a National Association for Science Writers’ Award for best magazine article. In 1998, he co-wrote a series on psychiatric research for the Boston Globe that was a finalist for the Pulitzer Prize for Public Service. His first book, Mad in America, was named by Discover magazine as one of the best science books of 2002. Anatomy of an Epidemic won the 2010 Investigative Reporters and Editors book award for best investigative journalism. He is the publisher of<a target="_blank" href="http://madinamerica.com/"> madinamerica.com</a>. He is a Clinical Assistant Professor (Adjunct) in the Lewis Katz School of Medicine at Temple University, Department of Psychiatry and Behavioral Science.</p><p><strong>Dr. Michael R. Montgomery is</strong> <strong>an existential psychoanalyst </strong>whose work explores the far edges of human experience, including complex trauma, extreme states, addiction, and the psychological aftermath of conflict. Trained at Regent’s University London, the Tavistock and Portman, and the Anna Freud Centre, his clinical work focuses primarily on community-based care for individuals often excluded from traditional mental health systems. He is faculty, and a supervising analyst at the New School for Existential Psychoanalysis, CA. He is the founder of<a target="_blank" href="http://logic23.com/"> Logic23.com</a> and<a target="_blank" href="http://peacefire.us/"> Peacefire.us</a> and a regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US. He has published more than 30 peer-reviewed works and is currently developing a new book alongside the psychophobia* podcast.</p><p>— —</p><p><strong>Episode Chapters</strong></p><p>00:00:05 – Intro & The Eli Lilly Admission</p><p>00:01:10 – Polypharmacy: The Rabbit Hole Without Evidence</p><p>00:04:20 – How to Get on More Medication: Try Coming Off</p><p>00:07:46 – The Interns, Stevie Nicks & Malaysia: Polypharmacy in Real Life</p><p>00:12:41 – Tony Stanton’s Residential Center & The Real Predictors of Distress</p><p>00:16:10 – A Thought Experiment & The Singer’s Demo CD</p><p>00:20:50 – What Actually Helps: Stories of Relationships</p><p>00:23:12 – The Broken Arm vs. The Human Condition</p><p>00:25:12 – The Creep of Risk & The Loss of Liberty</p><p>00:26:45 – Epistemic Destabilization & The Difference Between Real and True</p><p>00:31:03 – Crazy-Making: When Your Experience Is Discounted</p><p>00:33:30 – Mad in America the Platform: Origins, Mission & Global Affiliates</p><p>00:39:16 – Legacy & The Three Pillars of the Work</p><p>00:43:27 – When Did Recovery and Hope Become Conspiracy Theories?</p><p>00:46:15 – Othering as the Root of Cruelty</p><p>00:47:41 – Psychophobia, The Asterisk & The Centrality of Uncertainty</p><p>00:54:48 – Forced Treatment: The Hardest Question</p><p>00:57:40 – San Francisco, The Opioid Crisis & Societal Failure</p><p>01:06:06 – Open Dialogue in Finland & Why It Didn’t Export Well</p><p>01:12:59 – “How Can I Be of Help to You?”: A Philosophy of Care</p><p>01:15:09 – Closing: Hope, Optimism & The Future</p><p>— —</p><p>Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust.</p> <br/><br/>This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit <a href="https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1">psychophobia.substack.com</a>
June 9, 2026
Episode 08 Part I: When Treatment Becomes the Problem - How modern psychiatry lost the human being
<p>"These are not the side effects of the medication. <strong>These are the effects of the medication.</strong>" — R.D. Laing</p><p>— —</p><p><strong>The former head of the American Psychiatric Association once</strong> called Robert Whitaker "a menace to society." Bob says he'd put it on his gravestone. In this conversation, Michael traces the through-line from the unlikely apprenticeships that taught Bob to take seriously the people most of the world had discounted - driving a New York cab with no partition in the late 1970s, working the overnight desk at an SRO hotel, running a tutoring program inside Attica prison after the riots - to the 1998 Boston Globe investigation where he found himself holding two irreconcilable narratives: one from the experts, one from the patients. The book that followed, Mad in America, did something simple and unforgivable. It took the patients' story seriously, followed the data, and found that the data agreed with them. They walk through the World Health Organization's own cross-cultural findings, the Harvard study showing long-term outcomes had declined, the Harrow-Jobe data Bob brought back to the researchers themselves, and the central tragedy his decades of work circle back to: a model of care that transforms what could be episodic difficulties into lifelong chronic conditions.</p><p>The good news, Bob argues, is that the official narrative has collapsed in the research literature. The bad news is that prescribing practices haven't.</p><p>— —</p><p>"We have a form of care that transforms what could be episodic problems into chronic conditions." — Robert Whitaker</p><p>— —</p><p>Relevant Links</p><p>Follow us on</p><p><a target="_blank" href="http://psychophobia.com">psychophobia.com</a> |<a target="_blank" href="https://psychophobia.substack.com/"> Substack</a> |<a target="_blank" href="https://www.linkedin.com/in/drmontgomery23/"> LinkedIn</a> |<a target="_blank" href="https://instagram.com/psychophobia_project"> Instagram</a> |<a target="_blank" href="https://www.youtube.com/@psychophobia_project"> Youtube</a></p><p>Follow Bob</p><p><a target="_blank" href="https://www.madinamerica.com/">Mad In America</a></p><p>Books</p><p><a target="_blank" href="https://www.madinamerica.com/mad-america-book/">Mad In America</a> | <a target="_blank" href="https://www.madinamerica.com/anatomy-of-an-epidemic-2/">Anatomy of an Epidemic</a> | <a target="_blank" href="https://www.madinamerica.com/psychiatry-under-the-influence/">Psychiatry Under the Influence</a></p><p>Send us a message:<a target="_blank" href="https://www.speakpipe.com/psychophobia"> https://www.speakpipe.com/psychophobia</a></p><p>— —</p><p><strong>Robert Whitaker is an American journalist</strong> and author who has won numerous awards as a journalist covering medicine and science, including the George Polk Award for Medical Writing and a National Association for Science Writers' Award for best magazine article. In 1998, he co-wrote a series on psychiatric research for the Boston Globe that was a finalist for the Pulitzer Prize for Public Service. His first book, Mad in America, was named by Discover magazine as one of the best science books of 2002. Anatomy of an Epidemic won the 2010 Investigative Reporters and Editors book award for best investigative journalism. He is the publisher of<a target="_blank" href="http://madinamerica.com/"> </a><a target="_blank" href="http://madinamerica.com">madinamerica.com</a>. He is a Clinical Assistant Professor (Adjunct) in the Lewis Katz School of Medicine at Temple University, Department of Psychiatry and Behavioral Science.</p><p>— —</p><p><strong>Dr. Michael R. Montgomery is an existential psychoanalyst</strong> whose work explores the far edges of human experience, including complex trauma, extreme states, addiction, and the psychological aftermath of conflict. Trained at Regent's University London, the Tavistock and Portman, and the Anna Freud Centre, his clinical work focuses primarily on community-based care for individuals often excluded from traditional mental health systems. He is faculty, and a supervising analyst at the New School for Existential Psychoanalysis, CA. He is the founder of<a target="_blank" href="http://logic23.com/"> </a><a target="_blank" href="http://Logic23.com">Logic23.com</a> and<a target="_blank" href="http://peacefire.us/"> </a><a target="_blank" href="http://Peacefire.us">Peacefire.us</a> and a regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US. He has published more than 30 peer-reviewed works and is currently developing a new book alongside the psychophobia* podcast.</p><p>— —</p><p>Episode Chapters</p><p>00:00:05 – Intro & Why This Episode Took So Long</p><p>00:01:25 – The Yellow Cab: Driving New York 1978-1984</p><p>00:04:45 – No Partition: The Vulnerability of the Encounter</p><p>00:08:28 – The SRO Hotel, Orwell & The Stories Told at 3 AM</p><p>00:11:36 – Inside Attica: Tutoring After the Riots</p><p>00:17:59 – A Menace to Society: The Question</p><p>00:19:11 – The Boston Globe Series & Two Competing Narratives</p><p>00:24:48 – The Harvard Study & The WHO Cross-Cultural Findings</p><p>00:30:23 – Why Being Challenged Made the Work Stronger</p><p>00:31:27 – Anatomy of an Epidemic & The Harrow-Jobe Story</p><p>00:38:07 – Why Informed Consent Is Treated as a Threat</p><p>00:42:17 – Michael's Story: Walking Onto the Psychiatric Ward</p><p>00:43:39 – Malaysia & The Business of Big Pharma</p><p>00:48:25 – Two Impulses Behind Broken Care</p><p>00:50:04 – Episodic Problems Made Chronic</p><p>00:50:52 – Open Dialogue, The Collapse of the Narrative & Today's Mismatch</p><p>— —</p><p>Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust.</p> <br/><br/>This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit <a href="https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1">psychophobia.substack.com</a>
June 2, 2026
Episode 07: Use It or Lose It - The Brain, Lifelong Learning, and the Courage to Stay Curious
<p>“<strong>I am still learning.</strong>“ — Michelangelo, at age 87</p><p>—</p><p><strong>Sandy Halperin was a Harvard professor so brilliant</strong> he could deliver two-hour lectures from memory. A decade into his early-onset dementia diagnosis, Steve Orfield says he was still sharper than most people who didn’t have the condition. When Steve asked CNN’s producers why their ongoing feature kept telling the story of Sandy’s decline rather than what he was still able to do, they refused. It’s the kind of story that runs through every part of this conversation. The founder of Orfield Labs in Minneapolis is a polymath in the old sense -- self-taught in acoustics, lighting, architecture, philosophy of science, and at seventy-something, he says he learns twice as fast as he did in his fifties. He and Michael walk through the principle that anchors his work -- that the parts of the brain you use grow, and the parts you don’t shrink -- and the design philosophy it has produced: facilities for people with dementia where residents start engaging, socializing, and moving like they’re ten years younger; autism buildings that look “boring” to architects because they are quiet and simple, and work for that exact reason; an entire body of evidence that what we call decline is often the environment failing the person, not the other way around. Along the way: the autistic artists whose gestalt perception has taught Steve more than psychology departments, his fractional self-diagnosis of HD without the AD, the international dementia research award his first project won outright, and the worry that AI is quietly making us less able to finish our own setences.</p><p>If decline is not what we have been told it is -- if the right room can give a person with dementia ten years back, and the wrong room can take them -- then the harder question is what we have agreed to call inevitable, and who pays the price for it.</p><p>—</p><p>“<strong>In my 70s, I can learn twice as fast as I could in my 50s.</strong>“ -- Steven Orfield</p><p>— —</p><p><strong>Follow us</strong></p><p><a target="_blank" href="https://psychophobia.com/">psychophobia.com</a> |<a target="_blank" href="https://psychophobia.substack.com/"> Substack</a> |<a target="_blank" href="https://www.linkedin.com/in/drmontgomery23/"> LinkedIn</a> |<a target="_blank" href="https://instagram.com/psychophobia_project"> Instagram</a> |<a target="_blank" href="https://www.youtube.com/@psychophobia_project"> Youtube</a></p><p>Send us a message:<a target="_blank" href="https://www.speakpipe.com/psychophobia"> https://www.speakpipe.com/psychophobia</a></p><p><strong>Follow Steve</strong></p><p><a target="_blank" href="https://www.orfieldlabs.com/">Orfield Labs</a> |<a target="_blank" href="https://www.linkedin.com/in/steven-j-orfield/"> Steven Orfield on LinkedIn</a></p><p>— —</p><p>Steven Orfield is a pioneering polymath whose work spans acoustics, lighting, architecture, and sensory science. Founder of Orfield Labs in Minneapolis, he has spent decades designing environments that enhance human perception, from dementia and autism facilities to cutting-edge research in silence and sensory processing. Orfield combines rigorous science with a deep understanding of human experience, challenging conventional approaches to mental health and neurodiversity. He reframes cognitive differences as “filters” rather than deficits, using research and design to improve quality of life. A lifelong learner and innovator, his work demonstrates how thoughtful environments can unlock human potential and transform perception.</p><p>—</p><p>Dr. Michael R. Montgomery is an existential psychoanalyst whose work explores the far edges of human experience, including complex trauma, extreme states, addiction, and the psychological aftermath of conflict. Trained at Regent’s University London, the Tavistock and Portman, and the Anna Freud Centre, his clinical work focuses primarily on community-based care for individuals often excluded from traditional mental health systems. He is faculty, and a supervising analyst at the New School for Existential Psychoanalysis, CA. He is the founder of<a target="_blank" href="http://logic23.com/"> Logic23.com</a> and<a target="_blank" href="http://peacefire.us/"> Peacefire.us</a> and a regular contributor to the Society for Existential Analysis, the R.D. Laing Symposium, and ISPS-US. He has published more than 30 peer-reviewed works and is currently developing a new book alongside the psychophobia* podcast.</p><p>— —</p><p><strong>Episode Chapters</strong></p><p>00:00:05 – Intro & The Anechoic Chamber Challenge</p><p>00:02:00 – Peace, Polymaths & A Mind Without Boundaries</p><p>00:07:08 – 25 Years of Invisible Disabilities: Autism, Asperger’s & The Daily “Replay”</p><p>00:15:44 – Schizophrenia, Stubborn Children & The Limits of Diagnosis</p><p>00:18:44 – A Daughter Diagnoses Her Father: HD Without the AD</p><p>00:25:42 – How Orfield Labs Began: A Storefront, A Chamber & A Building Prince Walked Away From</p><p>00:34:51 – Use It or Lose It: The Brain at Seventy & The Sandy Halperin Story</p><p>00:40:44 – Filters, Not Deficits: Designing for Autism & Dementia</p><p>00:52:41 – Kumbaya Meetings, Veterans & Whale Sounds in the Chamber</p><p>00:56:54 – Carl Beam, Ojibwe Art & The National Gallery</p><p>01:01:32 – Objective Reality, The Frog & The Limits of Perception</p><p>01:10:59 – Stupidifying the Population: AI, Education & The Loss of Liberal Arts</p><p>— —</p><p>Please note that while I am a therapist, I am not your therapist. This podcast explores mental health and the human experience, but it is not a substitute for therapy, medical care, or professional advice. Any decisions regarding your mental health, including changes to medication or treatment, should be made in consultation with a qualified healthcare professional you trust.</p> <br/><br/>This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit <a href="https://psychophobia.substack.com?utm_medium=podcast&utm_campaign=CTA_1">psychophobia.substack.com</a>
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