She Doesn’t See Broken People. She Sees Terrain. with Dr. Arwen Podesta | Ep. 008

Dr. Arwen Podesta is an addiction psychiatrist in New Orleans who has spent her whole career sitting across from the people our culture has decided are the most broken among us — the addicted, the relapsed, the ones who keep reaching for the thing that’s hurting them. And here is what undid me about her: she doesn’t see broken people. She sees terrain. She sees a nervous system doing exactly what it learned to do to survive. She’s board-certified in psychiatry, addiction medicine, forensic psychiatry, and integrative medicine, and she built her practice on the many hands — psychiatry alongside nutrition, acupuncture, somatic work, story, and the natural world. 

She wrote a whole book, HOOKED, making the mechanics of addiction make sense, and then she spends her days reminding everyone that mechanics were never the whole story. We talk about addiction as intelligence rather than defect, about what real repair asks for that the fight narrative completely misses, about place as terrain in a city that knows something about collapse and something about coming back, and about the hunger underneath the substance — what people are actually starving for. She’s doing in the field of the mind almost exactly what I’ve tried to do in the field of the body. Her terrain is the nervous system. Mine is the cell. Same gospel, different soil.

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