MRCPsych on the Go: Revision Essentials

What if you slept twenty hours a day for weeks at a time, then woke up with barely any memory of it? In this episode, we explore Kleine-Levin syndrome, the rare recurrent hypersomnia nicknamed Sleeping Beauty syndrome, affecting roughly one to five people per million. We cover what an active episode looks like, and the classic three Hs of hypersomnia, hyperphagia and hypersexuality. We look at wha...

What happens in the brain when a burst of laughter makes your knees give way, while you stay completely awake? In this episode, we explore narcolepsy through the lens of the brain's sleep-wake circuitry. We cover the classic tetrad of excessive daytime sleepiness, cataplexy, sleep paralysis and hypnagogic hallucinations, and the difference between narcolepsy type 1 and type 2. We tell the sto...

If you were told, right now, that you could lie down and fall asleep within five minutes, would your body actually believe you? For most people with insomnia, the honest answer is no, and that gap sits at the centre of the entire disorder. In this episode, we open a five part series on sleep disorders, classified according to ICD-11. We cover how insomnia disorder is actually defined and diagnosed...

In 1780s Paris, patients sat around a wooden tub filled with iron filings and bottles of "magnetised" water, gripping rods that protruded from it, waiting to convulse. The man who invented this spectacle believed he'd discovered a new force of nature. He hadn't, but he'd stumbled onto something real anyway. In this episode, we close our series on states and levels of aware...

When a mother kills her own child while acutely mentally ill, is that murder, or is it an illness? The mistrial in the Lindsay Clancy case has put that exact question back in the headlines. Part 2 of 2. In our last episode, we covered the clinical picture of postpartum psychosis itself. In this episode, we follow up with the legal side: the Lindsay Clancy case in Massachusetts, the insanity defenc...

What if the same hormones that helped grow and deliver a healthy baby could, in a small number of women, also trigger a complete break from reality within days of giving birth? Part 1 of 2; Postpartum psychosis has been all over the headlines because of the Lindsay Clancy case in Massachusetts, so in this episode, we step outside our usual syllabus order to explain the illness itself properly.  We...

Every night, your brain spends part of its time paralysed and hallucinating, in a state that looks almost exactly like being awake. That's REM sleep, and it happens to all of us.  In this episode, we cover the structure of a normal night's sleep and the major theories of why we dream, the parasomnias that can intrude on sleep, and the biorhythms that govern when we sleep at all, along wi...

Why can a radar operator miss an obvious blip after two hours on shift, but catch it easily in the first ten minutes? The problem isn't their eyesight, it's how alertness itself behaves over time. We look at how the brain regulates arousal through the reticular activating system, why sustained attention reliably decays over time, the vigilance decrement, and how the same arousal circuits...

What if your mind wasn't one thing, but three, constantly negotiating with each other? One wants, one restrains, and one judges. That's Freud's structural model of the mind: the id, ego and superego. In this episode, we go beyond Freud's topographical model from episode 35, into his structural model of the mind, the ego's defence mechanisms, and his theory of psychosexual...

What do you call someone who forgets you entirely, then confidently tells you something that never happened? That's a patient with Korsakoff's syndrome. They can hold a normal conversation with you, then forget you were ever there the moment you leave. Ask them to explain the gap, and they won't lie. They'll fill it with something that feels completely true. In this episode, we...

Have you ever driven somewhere familiar and arrived with no memory of the journey itself? Something in your mind was clearly steering the car. It just wasn't the part you'd call "you." In this episode, we begin a new mini-series on states and levels of awareness. We start with the levels of consciousness themselves, from full alertness through the preconscious to the unconsciou...

Why do some people recover from adversity while others do not? What does resilience have to do with this? In this episode, we explore the psychology of resilience. We cover definitions of resilience, landmark research from developmental and clinical psychology, the factors that promote and undermine resilience, and the implications of resilience research for recovery-oriented psychiatric practice....

Do you believe that what happens to you is within your control, or largely down to chance? The answer to that question shapes how you respond to stress, setbacks and illness. In this episode, we explore three related concepts that illuminate individual differences in perceived control: Rotter's locus of control, Seligman's learned helplessness and Rosenbaum's learned resourcefulness...

Stress is not something that simply happens to you. How you interpret and respond to a stressful situation is just as important as the situation itself. In this episode, we explore Richard Lazarus and Susan Folkman's transactional model of stress and coping, one of the most influential frameworks in health psychology. We cover primary and secondary appraisal, the distinction between problem-f...

Two people can experience the same stressful event and respond in completely different ways. One develops depression; the other seems unaffected. Why? In this episode, we explore the factors that determine individual differences in vulnerability and resilience to stress. We cover biological, psychological and social vulnerability factors, and examine the landmark research of Friedman and Rosenman...

What happens when trauma is not a single event, but the air someone has breathed their entire life? In this episode, we explore complex PTSD. This is the ICD-11 diagnosis that captures the lasting impact of prolonged, repeated and inescapable trauma. We build on the core PTSD criteria from the previous episode. We focus on the additional features that define complex PTSD, why it is so often missed...

Why does a sound, a smell or a flash of light have the power to pull someone back into the worst moment of their life, years after it happened? In this episode, we explore post-traumatic stress disorder (PTSD) in depth. We cover the ICD-11 diagnostic criteria, the three core symptom clusters, and the neurobiology that explains why PTSD symptoms are so persistent and so difficult to simply talk you...

Not all stress comes from outside events. Some of the most corrosive stress arises from within, when we are pulled in opposite directions at the same time. In this episode, we explore the psychology of conflict and trauma. We cover the three classical types of motivational conflict described by Kurt Lewin, the psychological impact of traumatic experience, and the relationship between trauma and po...

Can a single life event make you physically ill? Research suggests it can, and the evidence is more precise than you might expect. In this episode, we explore the social origins of stress. We cover Holmes and Rahe's Social Readjustment Rating Scale, the landmark studies linking life events to illness onset, and Kanner's research on daily hassles and uplifts as independent predictors of w...

We all talk about feeling stressed, but what is actually happening inside the body when stress strikes? In this episode, we explore the physiology and psychology of stress. We cover Hans Selye's landmark General Adaptation Syndrome, the hypothalamic-pituitary-adrenal axis, the role of cortisol, and the distinction between acute and chronic stress. Topics include the three stages of Selye&apos...

Can the same emotion mean something different depending on who is feeling it, or where in the world they live? And does being more emotionally aroused always mean you perform better? In this episode, we explore the differentiation of emotions, the debate around primary emotions, and the relationship between emotional arousal and performance. Topics include Ekman's six primary emotions and his...

Can the same physical sensation produce completely different emotions? Schachter and Singer proved that it could, using nothing more than an adrenaline injection. In this episode, we explore cognitive appraisal theories of emotion, including Schachter and Singer's two-factor theory and the counterintuitive phenomenon of misattribution of arousal. We also examine Richard Lazarus's model o...

What if your fear and your racing heart arrive at exactly the same moment, neither one causing the other? In this episode, we explore the Cannon-Bard theory as a direct challenge to the James-Lange theory. We cover Cannon's four key criticisms of James-Lange, the role of the thalamus in generating simultaneous emotional and physiological responses, and LeDoux's low road model of fear pro...

Have you ever noticed your body reacting before your mind catches up?  In this episode, we explore what emotions actually are, breaking down the physiological, cognitive, behavioural and subjective components of emotional experience. We then examine the James-Lange theory, one of psychology's most counterintuitive proposals. Topics include the four components of emotion, the famous bear in th...

Why do some people thrive after trauma, while others struggle to recover? The answer might come down to which of their fundamental needs are being met. In this episode, we explore Maslow's hierarchy of needs, one of psychology's most iconic models. We cover all five levels of the pyramid, from basic survival through to self-actualisation, and explain why understanding unmet needs is esse...