Beyond Disorder: Redefining Identity, Meaning, and Healing with Dr. David Puder

Oct 23, 2025

Dr. David Puder, a seasoned psychiatrist and psychotherapist, shares insights on the intricate process of healing from complex trauma. He discusses the nuances of dissociation, emphasizing how early attachments shape these responses. Puder introduces innovative tools like his Connection Index for enhancing clinical empathy. He highlights the importance of narrative, using writing and dreams to access suppressed emotions. Additionally, he stresses the value of personal therapy for clinicians and the impact of reflective function on treatment outcomes.

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ADVICE

Convert Medical Identity To Personal Strengths

Convert highly medicalized patients into psychotherapy patients by redirecting attention from diagnosis to strengths and emotional needs.
Invite families into therapy to shift illness-based roles and restore congruent emotional connection.

INSIGHT

Complex Trauma Often Shows As Withdrawal

Complex trauma often presents as interpersonal withdrawal and dissociation rather than classic PTSD reactivity.
Viewing coping styles as personality adaptations (not fixed disorders) reframes treatment and reduces stigma.

INSIGHT

Disorganized Attachment Predicts Lifespan Dissociation

Early misattunement predicts disorganized attachment which can evolve into dissociation across development.
Dissociation becomes the central risk marker from childhood into adulthood more than a single diagnostic label.

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"The work we do is meaningful, sometimes difficult, but it's the best work to do." - Dr. David Puder

On this episode of Transforming Trauma, Emily Ruth welcomes psychiatrist and psychotherapist Dr. David Puder to explore the clinical realities of complex trauma and the slow, often gritty path toward healing. Drawing on decades of hospital and outpatient experience, Dr. Puder offers candor and practical wisdom for clinicians and caring professionals who feel the weight of this work.

The pair discuss how complex developmental trauma shows up as dissociation and psychogenic symptoms rather than classic shock-based PTSD, how medical identities can eclipse a person's strengths, and ways to help families shift out of illness-based roles. You'll hear how dreams and creative writing can reveal disavowed material, why rare countertransference reactions are clinical clues, and how therapist reflective function — the ability to make meaning of inner reactions — predicts treatment impact. Dr. Puder also explains practical tools he developed, including a Connection Index for clinical teams, and offers concrete examples of converting medical patients into psychotherapy patients so they can reclaim agency and a life beyond diagnosis.

We invite you to listen to the full episode and follow Transforming Trauma on Apple Podcasts, Spotify, YouTube, or your favorite podcast app.

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SPACE:

SPACE is an Inner Development Program of Support and Self-Discovery for Therapists on the Personal, Interpersonal, and Transpersonal Levels offered by the Complex Trauma Training Center. This experiential learning program offers an immersive group experience designed to cultivate space for self-care, community support, and deepening vitality in our professional role as therapists. Learn more about how to join.

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The Complex Trauma Training Center: https://complextraumatrainingcenter.com

View upcoming trainings: https://complextraumatrainingcenter.com/schedule/

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The Complex Trauma Training Center (CTTC) is a professional organization providing clinical training, education, consultation, and mentorship for psychotherapists and mental health professionals working with individuals and communities impacted by Adverse Childhood Experiences (ACEs) and Complex Trauma (C-PTSD). CTTC provides NARM® Therapist and NARM® Master Therapist Training programs, as well as ongoing monthly groups in support of those learning NARM. CTTC offers a depth-oriented professional community for those seeking a supportive network of therapists focused on three levels of shared human experience: personal, interpersonal & transpersonal. The Transforming Trauma podcast embodies the spirit of CTTC – best described by its three keywords: depth, connection, and heart - and offers guidance to those interested in effective, transformational trauma-informed care.

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