In this powerful 10-minute episode, Dr. Raymond Zakhari, DNP, triple board-certified nurse practitioner and combat veteran, explores the hidden patterns of addiction that affect Manhattan's most successful professionals. From the ritual of unwinding after demanding days to the subtle progression of dependency, this episode reveals why high-achieving individuals are increasingly turning to alcohol, cannabis, gambling, and other escapes. Dr. Zakhari examines the alarming rise in substance use amon...
Aug 15, 2025•10 min
When Men Go Numb: Depression as a Survival Response In this compelling episode, we unravel the hidden ways depression uniquely manifests in men—not as sadness, but as numbness, burnout, and emotional shutdown. Through expert insight and real-world examples, you'll discover how the male nervous system uses "functional freeze" as a deeply wired safety strategy. We explore the roots of this survival response in childhood environments, chronic stress, and modern pressures to perform, revealing why t...
Jul 17, 2025•18 min
🧠 Episode Summary: In this episode of The Psychology of It All, Dr. Raymond Zakhari explores why psychiatric treatments work for some but not others. It’s not just about the medication—it’s about the person receiving it. Using clear analogies and real-world clinical examples, Dr. Zakhari demystifies the concepts of moderators, mediators, confounders, and biomarkers—revealing how these variables shape treatment outcomes in depression and beyond. You’ll learn: Why some patients respond well to an...
Jun 14, 2025•15 min
Episode Title: From Trials to Trust — Seeing Through the Fog of Psychiatric Research Podcast: The Psychology of It All Host: Dr. Raymond Zakhari, NP Why do some medications seem to work in studies but fall short in real life? In this episode, Dr. Raymond Zakhari walks you through the hidden layers of psychiatric research—from p-values and placebo effects to Type I, II, and III errors. Learn how small design choices can distort big findings, how to tell the difference between statistical signific...
Jun 04, 2025•22 min
In this episode of “Beyond the Pill: Demystifying Evidence, Numbers & Causation in Psychopharmacology,” we pull back the curtain on how psychiatric medications earn their stripes—and what their numbers really mean. You’ll learn: • Why all studies aren’t created equal, from meta-analyses and randomized controlled trials down to cohort studies and case reports, and the ethical or practical reasons behind each design. • How to interpret NNT (Number Needed to Treat) and NNH (Number Needed to Har...
May 30, 2025•37 min
The holidays can be a joyful time, but for professionals and recovery. It also brings the unique stressors and challenges that increase the risk of relapse in this episode. Dr. Raymond Zakhari will explore 10 common risk factors that professionals face during the holiday and provide some practical strategies for maintaining sobriety for managing holiday stress and peer pressure to navigating emotional triggers and environmental cues Tune in to learn how to stay resilient focus focused, and conne...
Nov 15, 2024•16 min
Much of the benefit of psychotherapy happens between visits. You may have not felt anything during the visit or you may have had a lot more to say. This podcast will help you organize your thoughts and help you do the work of therapy between sessions.
Jul 31, 2023•5 min
The post Mortem analysis, and failing to achieve your goal, cognitive behavioral therapy strategies to help you achieve your goal
Jul 24, 2023•10 min
Cognitive behavioral techniques used in therapy to help you change a behavior to improve your health #self-analysis #SelfImprovement #CBT
Jul 17, 2023•10 min
Cognitive behavioral therapy paced pursed respiration exercise, and 4-7-8 breathing exercise
Jul 11, 2023•7 min
CBT for Insomnia Strategies: One effective treatment for insomnia is Cognitive Behavioral Therapy (CBT). Here are some CBT strategies that you can try: Sleep Hygiene: Sleep hygiene involves creating a sleep-conducive environment and developing habits that promote good sleep. This includes creating a dark and quiet sleeping environment, avoiding caffeine and alcohol before bedtime, and sticking to a consistent sleep schedule. Resources: National Sleep Foundation: Sleep Hygiene Tips Relaxation Tec...
Apr 06, 2023•6 min
Recommend solutions: deep breathing and relaxation exercises standing up every hour to take a walk and deep squat· staying hydrated soaking in a hot tub #jockstraps (support and natural hang NOT compression or pouch (can also provide some modesty if you get a #prostatemassage) Show notes: ARE YOU A TIGHT ASS? WHAT YOUR PELVIC FLOOR SAYS ABOUT YOUR MENTAL HEALTH AND WELLNESS? https://www.metromedicaldirect.com/2017/05/02/what-does-your-pelvic-floor-say-about-your-mental-health/ NONBACTERIAL PROST...
Mar 30, 2023•7 min
A description of the modern men’s physical exam and what you should expect. How to get the most out of your health care experience to promote your health. MetroMedicalDirect.com check out the blog The Whole Package to see if an Executive physical is right for you.
Jun 23, 2022•7 min
Alzheimer’s dementia vascular dementia Lewy body dementia: strategies to talk to loved ones who may be suffering with dementia. Medical and psychiatric housecalls in Manhattan
Jun 06, 2022•13 min
Premature ejaculation occurs when a man ejaculates (cum) too soon. It can be as early as the thought of sex or if it occurs in less than 2 minutes after your penis enters your partner. Premature ejaculation is a common sexual complaint of both men and women. Up to one-third of men can experience this sexual dysfunction at one time or another for various reasons. As long as it is not the pattern of usual performance it is generally not a cause for concern. The diagnosis of premature ejaculation r...
Jul 31, 2020•9 min•Season 2Ep. 1
Have you ever wondered how a psychiatric diagnosis is made? Unlike other medical specialties there are no blood tests, or brain scans that prove that someone has a mental illness. The steps that the psychiatrist should take in formulating a diagnosis include making sure your behaviors are not due to an underlying medical condition, and that it is not caused by some substance you are taking. For example marijuana can cause people be feel and act paranoid, cocaine can make someone act and feel gra...
Jun 28, 2019•6 min
Sex therapy can help couples and individuals understand their core sexual script that plays out in their daily life. It can help address sexual problems related to relational conflicts such as arousal and orgasm difficulties. Sex therapy can help facilitate conversations about needs and desires. You can ask questions on Twitter @MetroMedicalNY or on the Facebook page @DrRaymondZakhariNP
Jun 08, 2019•6 min
In therapy the use of silence is very helpful in allowing the client to speak freely. The therapist is listening for more than the content of you speech. I am listening for how you say it, when you say it, the order in which you say it, the number of times you repeat yourself, while looking at your reaction to the words coming out of your mouth. I am also listening for your fantasies about the situation and how that relates to your life. The work of therapy begins with Change Talk which makes it...
Apr 23, 2019•7 min•Season 1Ep. 17
Abuse in teen dating relationships can and does occur, but because it is so unexpected it often goes missed by parents. There 5 common types of abuse that can occur. They are physical, sexual, emotional, psychological (mental), and financial. Abusers can be either male or female as can their victims. Parents should remain vigilant in the dating lives of their children, and pay special attention to isolating behaviors. Parents should be especially attuned to changes in personality with the onset ...
Mar 15, 2019•8 min
Cognitive distortions are the biased perspectives we take on ourselves and the world around us. They are irrational thoughts and beliefs that we have unknowingly reinforced over time. The first step to behaving rationally is to be aware of our biases and work to achieve a balanced perspective. I am going to talk about 2 cognitive distortions one of which has 2 parts. The first is Disqualifying the positive: Disqualifying the Positive can be difficult to identify sometimes, because you have the p...
Feb 04, 2019•6 min
Today I am going to continue going through cognitive distortions . Like defense mechanisms, a cognitive distortion is a habit of mind that we rapidly deploy to convince ourselves how right we are in our understanding of the circumstances around us, for the purpose of reducing our perception of distress. For more on defense mechanisms download and listen to the previous episodes. Short of a life-threatening situation it is wise to second guess what your brain is telling you. Our minds have develo...
Jan 25, 2019•6 min
For the next few weeks, I am going to be explaining Cognitive Distortions and the role they play in self-sabotage. So let me begin by first defining what I mean by a Cognitive Distortion. Cognitive distortions are the biased perspectives we take on ourselves and the world around us. They are irrational thoughts and beliefs that we unwittingly reinforce over time, to the point where they become automatic and almost reaction like. If you recall from the previous series on Defense Mechanisms, react...
Jan 08, 2019•7 min
Today I am going to talk about 3 mature defense mechanisms, and I will conclude with a list of 10 behaviors to help you Screen Mr. or Miss right in 2019: Humor is an adaptive technique to help us to cope with tense or stressful situations. Requires a bit of humility (our 2nd defense mechanism today) to use this tactfully. It requires us to lower our expectations, sacrifice our pride and focus on the well-being of others which will be our third mature defense mechanism, altruism. The use of humor...
Dec 31, 2018•11 min
Continuing with explaining how some defense mechanisms help us self-sabotage and limit our success. This episode will cover displacement (socially unacceptable) and sublimation (socially acceptable). Also, identification with the aggressor (sometimes called Stockholm Syndrome), and reaction formation (acting in the exact opposite manner than what you really feel).
Dec 24, 2018•9 min
The psychology of it all helps people become aware of the self-sabotaging behaviors we all do from time to time. This episode explains the defense mechanisms of avoidance and repression. There is a psychotherapy DIY 5 step process to help you avoid the couch and stop avoidance coping. Step 1 Recognize it does not work Step 2 Answer the question: What have you been trying to avoid? What is making you feel awkward? What is making you anxious? What thought is convincing you that you are not good en...
Dec 11, 2018•14 min
This is episode 5 in the series The Psychology of It All. A defense mechanism is an unconscious psychological reaction to reduce mental anguish arising from an unacceptable stressor. Denial is characterized by unconsciously blocking out events or stressors from conscious awareness in order to reduce mental stress and anguish. Rationalization is a person’s self-justifying explanation of an alternate and more tolerable reality that will often downplay the severity of objectively verifiable reality...
Nov 30, 2018•8 min
Defense mechanisms are unconscious psychological reactions to reduce mental stress. Becoming self-aware of personal maladaptive coping strategies can increase the chance of learning new ones that are not sabotaging in nature. This episode covers dissociation, acting out and blocking.
Nov 23, 2018•7 min
Somatization is a physical symptom caused by a psychological problem. A defense mechanism is a reaction of the mind designed to protect the person for mental distress. Defense mechanisms are not volitional, and everyone uses them.
Nov 16, 2018•7 min
Defense mechanisms are an automatic response that helps us deal with stress. Regression is an immature defense mechanism that can manifest in both adults and children during stressful times. Dr. Raymond Zakhari is triple board certified nurse practitioner in private practice in New York City. He provides medical and psychiatric house calls. www.MetroMedicalDirect.com
Nov 09, 2018•5 min
A review of defense mechanisms and common cognitive distortions that lead to our detriment. Being aware of these mind games can help train our reaction so that we are well-adjusted members of society.
Nov 02, 2018•7 min
