psychophobia* podcast “Madness need not be all breakdown. It may also be breakthrough.” — R.D. Laing — — What if the institutions designed to help us understand the human psyche are actually afraid of them? Hosted by Dr. Michael R. Montgomery, this podcast explores the uncomfortable questions. Together, we’ll examine how the mental health systems meant to heal us instead perpetuate cycles of dependency. Welcome to the psychophobia* Podcast. Leah Giorgini has lived on both sides of the psychiatric system - as a patient diagnosed with psychosis in her teens, and as a clinician working inside the very institutions she once feared. In this conversation, she and Dr. Montgomery pull apart the seams of modern mental health care: the DSM’s grip on human suffering, the silent violence of self-stigma, and why the fire truck shows up when all you needed was someone to sit with you for two hours. They confront the uncomfortable truth that care, real care, can’t be billed, coded, or timed. And they ask the question the system refuses to answer: what if recovery isn’t about fixing someone, but returning their agency to them? “No one is coming. And when people find their own agency, they are liberated.” — Dr. Michael R. Montgomery — — Relevant Links Follow us on psychophobia.com | Substack | LinkedIn | Instagram | Youtube Follow Leah ISPS-US | Leah Giorgini on Linkedin Send us a message: https://www.speakpipe.com/psychophobia — — Leah Giorgini is an occupational therapist and a person with lived experience of psychosis. She serves as Executive Director of ISPS-US (the International Society for Psychological and Social Approaches to Psychosis), an organization that questions whether conventional psychiatry has misunderstood some of the most extreme states of mind. Her work focuses on trauma-informed and recovery-based approaches that attempt to understand psychosis as a human response to overwhelming experience rather than simply a disease to be medicated away. 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 Logic23.com and Peacefire.us 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. — — Episode Chapters 00:00 — Introduction & What Is Psychophobia? 00:45 — The DSM-5: Bible or Blunt Instrument? 02:28 — Defining Psychosis — and Leah’s Own Story 04:13 — Stigma, Self-Stigma & Identity After Diagnosis 09:16 — Medication, Hospitals, and the Pharmakon Idea 11:29 — The Pharmakon Paradox: When Treatment Is Also the Poison 14:17 — Culture, Anti-Psychiatry, and Carceral Trends 16:23 — Crisis, Containment, and Systemic Failure 19:26 — Crisis Response: the Fire Truck, Police Car & Ambulance 23:41 — Trauma, Meaning, and “No One Is Mad” 26:49 — UK vs. US Systems & McDonaldization of Care 29:29 — No Tick Box for Love 32:47 — What Actually Helps in Crisis? 36:30 — Iatrogenic Harm and Tick-Box Care 39:55 — Agency, Iatrogenic Harm & What Recovery Actually Requires 41:36 — Clozapine, “Treatment Resistance,” and Medication Dogma 49:20 — Love, Therapy, and Dependency vs. Self-Efficacy 51:44 — Homelessness, Housing First, and Basic Needs 59:58 — Agency, Suicide, and the Limits of Non-Intervention 1:06:53 — Radical Agency, Neurodiversity, and Knowing Your Mind 1:09:56 — Rediscovering Agency as the Heart of Recovery 1:14:02 — “No One Is Coming” and the Fear of Suffering 1:16:30 — The Painful Work of Healing & Safety as a Precondition 1:19:26 — ISPS-US, Informed Consent & What’s Next 1:22:58 — ISPS-US: Conferences, Negative Symptoms & Advocacy 1:24:58 — Informed Consent, Polypharmacy, and Veterans 1:26:08 — Closing Reflections: Hope, Momentum & Mutual Support 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. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychophobia.substack.com