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
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1:17:31
Alcohol: Examining Alcohol culture, history, and use disorder
In Episode 15, Preston and Margaret open a bottle—of questions, stories, and science—about alcohol use disorder. What do we get wrong about “moderate” drinking? Why is detox more dangerous than most people realize? And how does alcohol quietly reshape identity, relationships, and the brain itself? With their signature blend of honesty and humor, they explore the unexpected ways drinking shows up in medicine, the myths that keep us stuck, and the messy, meaningful path to redefining recovery.
Takeaways:
What if “just a drink” isn’t so simple? Preston and Margaret explore how subtle patterns can blur the line between social drinking and something more.
Could quitting be more dangerous than drinking? There’s a reason detox needs to be taken seriously—and it’s not what you think.
What does alcohol really do to your brain? Let’s just say it’s a little more complicated than relaxation and red wine.
Why don’t we talk about medication for alcohol use disorder? The answers are as cultural as they are clinical.
Is recovery a destination—or something else entirely? Margaret and Preston unpack a version of success that doesn’t always fit the script.
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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1:34:00
Social Anxiety & the Loneliness Epidemic
In Episode 14, Preston and Margaret dive into social anxiety disorder and the loneliness epidemic. From embarrassing childhood memories to awkward club encounters, they explore how social anxiety shows up in everyday life and how it differs from normal nerves. They also discuss the surgeon general’s definition of loneliness, the role of social media in increasing perceived judgment, and the neuroscience behind facial recognition, fear responses, and serotonin's impact on the amygdala.
Takeaways:
Social Anxiety Is More Than Shyness: It becomes a disorder when it causes persistent distress, distorted perceptions of judgment, and leads to avoidance of meaningful activities.
Loneliness Is Subjective—and Epidemic: According to the U.S. Surgeon General, loneliness stems not just from solitude but from perceived lack of meaningful connection, and it has major mental and physical health consequences.
Social Media Can Amplify Anxiety: Being constantly seen—and judged—online may intensify social anxiety, even for those who appear confident or well-known.
Your Brain Is Wired to Care: Structures like the amygdala, insula, and anterior cingulate cortex play key roles in social fear, facial recognition, and rejection sensitivity—and they’re all modifiable with therapy and medication.
Healing Is Gradual and Personal: CBT, SSRIs, and compassionate exposure therapy can retrain the brain’s fear circuits—but treatment must match the individual’s goals, beliefs, and readiness for change.
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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