John M. Talmadge, M.D.

A Blog Covering Many Topics

Public Speaking & Talks

New topics in 2015!
I've also included a list of topics from my speaking schedule over the past few years. I've noted the talks that got the highest reviews, which means that at least 90% of the reviews were 4 or better on a 5 point scale. Some talks did not include feedback, but the topics listed here have all been well received.

If your organization would like to schedule a talk, lecture, or workshop, give me a call. As my schedule permits, I am happy to speak for churches, schools, parent groups, and not-for-profit organizations at no charge.

New in 2015!
Four Sides to Every Story: Understanding and Helping the Whole Patient (highly rated)
Mindfulness: An Essential Practice in Recovery from Alcohol and Drugs
Beyond Motivation: The Positive Psychology of Excellent Addiction Treatment
Beyond the Basics: The Advanced Course in 12 Step Recovery
When Therapy Fails: Troubleshooting and Solutions

Mental Health Topics

Stress, Depression, and Burn-out (highly rated)
The Problems of Anxiety and Depression
What is Bipolar Disorder?
Chronic Mental Illness and the Seriously Mentally Ill
Attention Deficit Disorder: Causes, Concerns, and Cures
Alcohol and the Family (highly rated)
PTSD: Myths and Realities
Gambling: Deadly Odds and Destructive Desires
Street Drugs: The Facts
Addictions and the Future of Theory and Practice
Veterans and the VA: Hard Times for Mental Health (highly rated)

Family Topics
Scientific Evidence About Happy Marriages (highly rated)
Keys to Happier Relationships (highly rated)
ADD: What Parents Need to Know (highly rated)
Talking With Children About Drugs and Alcohol
Oppositional Children and Difficult Behavior (highly rated)
Marriage: How It Works, How It Breaks Down, How to Fix It
How My Wife Raised Three Successful Children (With My Help)
Single Mothers and Their Daughters (highly rated)
Raising Responsible Children
Families of Divorce
Yes Is a Dangerous Word (The Price of Permissiveness)
Youth Suicide: What We Know, What We Don’t Know
Learning Differences: Understanding How the Brain Is Wired

General Topics
An Introduction to Mindfulness (highly rated)
An Introduction to Positive Psychology (highly rated)
What is Personality? The Nine Types of People You Know (highly rated)
Emotional Intelligence: Hot Topic or Hot Air?
How Poker, Bridge, and Chess Prevent Alzheimer’s Disease
Why Philosophy Matters
Happiness: The Facts
A Short History of Psychology and Psychiatry
My Time on Death Row: A Huntsville Memoir

Topics in Spirituality
Why Does God Allow Suffering? (highly rated)
The Importance of Spiritual Practice and Discipline (highly rated)
Why Is Prayer So Difficult?
Religion and World Problems
The Dangers of Fundamentalism (highly rated)
Belief and Reality: What’s the Difference?

Treatment Philosophy

My work includes general psychiatric problems like anxiety, depression, attention deficit disorder, substance abuse, family conflict, childhood behavior, stress, and other issues. Many people know me through my work as a specialist in the treatment of alcoholism and other addictions or chemical dependencies.

My approach to psychiatric practice reflects many years studying human nature and working to help people who are having a hard time in life. By the time most people see a psychiatrist, they are worried, or they are sad, or they are very confused about something I will just call “the problem,” or “the complaint.” Let me make some general comments about my approach, and then I will discuss my thinking on the use of medications.

People seek psychiatric help for a variety of problems, but everyone wants the same result: to feel better, to think more clearly, to rediscover satisfaction and happiness, and to regain a sense of self control and personal freedom. The problem may be related to mood, energy level, motivation, sleep, worry, relationships, anger, troubled behavior, obsessions, compulsions -- it’s a long list. People who drink too much, use drugs, or misuse prescription medication are often using these chemicals to find relief. Alcoholism and substance abuse are widespread in our culture.

Dealing with life is never easy.

Most persons first try to solve the problem or deal with the complaint on their own. Frustrated that things aren’t improving, they may seek advice from others. Sometimes a person hides the problem or lives in silence with the complaint. They may read a book, go to a support group, consult the internet, or try a new religious practice. We all have problems and complaints, and we all do the best we can to solve the dilemmas of life. When someone calls me about consultation, I almost always hear them say that they have a problem, they have tried to solve the problem, and they are looking for someone who knows how to help make things better.

One of the individuals consulting with me said, “I feel like I’m in a box, and the directions for getting out of the box are printed -- on the outside of the box.”

A successful airline pilot, a Vietnam combat veteran, said, “Doc, I’m out of altitude, airspeed, and ideas.”

Often the person seeking help has waited so long that demoralization has begun to set in, and they are beginning to lose hope. This doesn’t mean that the individual is suicidal or, in fact, any more unhappy than many of the people at the workplace or in the neighborhood. It means that they are resigned to always feeling this way, never feeling any better than this. Demoralization means a state of mind in which a person considers accepting fate, giving up, and abandoning the idea that things can get better.

Fear, anger, resentment, feeling constantly wounded, feeling overwhelmed, feeling unappreciated, feeling worthless -- all of these emotions are part of our lives. But when we feel negative all the time, or most of the time, most days, then we need help. There are very few emotional problems that defy intelligent therapy and reasonable efforts toward a solution.

When I meet someone for the first time in consultation, I have three major concerns. First, I want to get to know the person and hear about the problem are the complaint. My first question usually is simply, “How can I help?” or “What brings you to see me?” Second, I want to explore the individual’s point of view or understanding of the problem, including what solutions have been attempted. Third, I want to consider what we can do, working together, to improve the situation. I tend to focus more on results than on reasons. I’m not always sure about why things happen, but I am very focused on what we can do now. Sometimes I explain in detail how the brain works, and sometimes I discuss how life works. The process of recovery involves growth, change, and even personal transformation.

Research shows that psychotherapy can help, medication can help, and intelligent problem solving helps. Psychotherapy is not for everyone, and medication is not for everyone, but the vast majority of people who want help can find it. One of my favorite expressions is, “You have to do it yourself, but you can’t do it alone.”

Over the years I have developed a style that I call “sober conversation.” The word “sober” does not apply just to alcohol and addictions. To be sober is to be serious, to focus on what is most important, and to try to get it right. I believe in the importance of what we care about, and in this regard I have seriously studied the specific problem of human will. I call it “the problem of human will” because we are often confused about what we will ourselves to do, or not to do. When I work as a psychotherapist, I am most interested in what people care about, how their beliefs and assumptions about life have been formed, and where they feel stuck or at odds with themselves. Sometimes we have conflicting feelings about the same thing. For example, someone wants to take life in a certain direction, but he or she feels conflicted about it. Or someone tries to solve a problem, not realizing that it’s part of a bigger problem, or a different kind of problem. My definition of psychotherapy is that it is a form of personal consultation, focused on the situation of the client, with the goal of solving problems and feeling better.

Not everyone is cut out for in-depth or long-term conversation. Some people like to come for a few visits, and some like to keep going for weeks, or even months on a weekly basis. Some people prefer to come two or three times a week because they want to do the work and get on with whatever is next. Some people come for an hour, and some come for an afternoon.

Psychotherapy does take time, because the process is basically two people getting to know each other in the context of a specific purpose. Psychotherapy at its best is about taking life seriously, getting it right, and feeling the satisfaction that comes from clarity of thought, commitment to integrity, and comfort with the complexity of one’s own emotions and ideas. Some say that psychotherapy is a dying art, and this may be true. Psychiatrists today (and perhaps psychologists as well) do not receive the extensive training in psychotherapy that we did thirty years ago. Many psychiatrists and psychologists are not interested in psychotherapy. And many psychotherapists are not really very good or very well trained. Today there are thousands of people who call themselves “life coaches,” and anyone can hang out a shingle and call himself a “life coach.” There are several private organizations that offer “certifications,” but there are no license requirements, there is no government regulation, and no educational standard that is generally accepted. For these reasons, I think the concept makes sense, but in practice let the buyer beware -- caveat emptor!

Medications can be very helpful in treating some specific psychiatric problems. Today we have excellent medications for anxiety, depression, moodswings, insomnia, attention deficit disorder, and other conditions. Bipolar disorder, for example, is a devastating condition that can be very effectively managed with medication, restoring individuals to a life of normalcy and stability. I have absolutely no doubt about the value of psychiatric medications. I also believe that what is most important is getting the right diagnosis and the correct strategy for intervention and treatment. I see many people who have been misdiagnosed, and even mistreated, because they have not been well assessed. Assessment can take time, and I never jump to conclusions about diagnosis. After knowing someone for a few weeks, together we may decide that we see the condition in a different way.

Psychiatric medications are powerful, effective tools when used properly, but they also have side-effects, and they are expensive. Getting the right medication for the right diagnosis is extremely important. And there is an old saying from Hippocrates, creator of The Hippocratic Oath: “It is more important to know what sort of person has a disease than to know what sort of disease a person has.“

Thoughts and Reflections

My mission in life is to use my skills as a physician (M.D.) and psychotherapist to help people. As a psychiatrist, I serve individuals and families across a wide range of conditions and diagnoses. To read more about my professional credentials and to read my biographical sketch, click here. When I assembled this website five years ago, I didn't have a blog, and I didn't update very often. Recently I've decided to be a bit more spontaneous, adding thoughts and reflections here from time to time. This blog will reflect some of my continuing thinking, learning, and exploration.


Psychiatry as a medical specialty is a vast—and often uncharted—territory. The basic education of a psychiatrist is highly scientific and technical. The first two years of medical school are purely basic science: anatomy, physiology, biochemistry, microbiology, and so on. The last two years include brief exposure to psychiatry and psychology, but most of the time is devoted to medicine, surgery, ob-gyn, and pediatrics. Internship and residency years in psychiatry involve patient care, but the psychiatrist’s true education begins after graduation. As the venerable Dr. Eugene Stead used to tell us at Duke, “Medical school is where you stay until you’re old enough to learn how to be a doctor.” The education of the good psychiatrist is a process that lasts a lifetime.

Thanks for reading!