Self Careapist Therapist Podcast
How do you actually use EMDR, CBT, or IFS in session, not the textbook version, but with a real client sitting across from you? Self Careapist Therapist is a therapist-to-therapist podcast where licensed clinicians break down the
clinical skills, modalities, and hard conversations that training programs skim over.
Hosted by Lorain Moorehead, LCSW, PMH-C, EMDR Certified Approved Consultant, Clinical Supervisor, and graduate school faculty associate. Each week features expert guests, including researchers, authors, and practicing clinicians, sharing
evidence-based interventions you can take straight into your next session.
Topics include:
• EMDR therapy, trauma processing, and advanced EMDR applications
• Internal Family Systems (IFS), parts work, and integrative trauma approaches
• CBT, DBT, RO-DBT, ACT, and third-wave cognitive behavioral therapies
• Clinical supervision, therapist training, and professional development
• Trauma, complex trauma, PTSD, CPTSD, and nervous system regulation
• ADHD, autism, neurodiversity-affirming assessment and treatment
• Therapist burnout, perfectionism, compassion fatigue, and sustainable self-care
• Couples therapy, attachment theory, and relational wounds
• Anxiety, OCD, and exposure-based interventions
• Grief, prolonged grief disorder, and meaning-making
• Suicide risk assessment, CAMS, and crisis intervention
• Parent-child therapy, adolescent anxiety, and family systems
• Perinatal mental health
• Ketamine-assisted psychotherapy and emerging modalities
• Clinical ethics, risk management, and culturally responsive practice
• Private practice development, insurance, and building a sustainable career
Questions we answer:
• How do I use EMDR, CBT, DBT, or ACT in real-life sessions, not just textbook examples?
• How do I choose which therapy modality to learn next?
• How do other therapists handle burnout and compassion fatigue?
• How do I integrate different modalities instead of feeling like I'm doing them wrong?
• When should I use IFS parts work versus EMDR reprocessing?
• How do I grow as a therapist after grad school or licensure?
• How do I make my practice more trauma-informed and culturally responsive?
• How do I find my niche or specialty as a clinician?
• What does evidence-based therapy actually look like in practice?
• How do therapists cope with imposter syndrome and self-doubt?
• How do I explain complex therapy concepts to clients in simple language?
• What is the best podcast by therapists, for therapists?
Whether you are a seasoned clinician or a graduate student, every episode is designed to sharpen your clinical thinking and reconnect you with the curiosity that makes therapy meaningful. Conference-level education and psych journal-quality conversations delivered while you drive, walk, or decompress between sessions.
Many episodes offer a free CEU for licensure in Arizona through the Board of Behavioral Health Examiners. Content is relevant for continuing education across LCSW, LMHC, LPC, LMFT, NCC, NBCC, and psychology licensure.
Subscribe and leave a review. It helps other therapists find the show.
Self Careapist Therapist Podcast
Radically Open DBT (RO-DBT): A Clinical Approach to Emotional Overcontrol With Ellen Astrachan-Fletcher
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Your most contained, rule-following, hardest-working clients may be the ones standard DBT is least equipped to help.
In this episode of Self Careapist Therapist, I sit down with Dr. Ellen Astrachan-Fletcher, lecturer at Northwestern University's Feinberg School of Medicine, Associate Professor of Psychiatry at UIC, and owner of EAF ReCenter. With over 30 years of clinical and teaching experience, Dr. Astrachan-Fletcher is a nationally recognized expert in both DBT and Radically Open DBT (RO-DBT). She is the co-author of two clinical workbooks used in eating disorder treatment programs across the country, and her third book, RO-DBT for Anxiety, is set for release in August 2026.
We cover what RO-DBT is, who it's designed for, how it differs from standard DBT, and what a training path looks like for clinicians who want to learn it.
What You'll Learn in This Episode:
Radically Open DBT was developed by Dr. Tom Lynch after observing that many clients, particularly those with chronic depression, restrictive eating disorders, and anxiety, were not responding to standard DBT. Standard DBT targets emotional dysregulation, helping clients learn to contain and control. RO-DBT does the opposite: it targets emotional overcontrol, the pattern of holding emotions in, appearing fine, and disconnecting from authentic social signaling.
Dr. Astrachan-Fletcher explains the concept of emotional leakage, the moments when a tightly controlled client expresses emotion in unexpected, often indirect ways. She walks through the three core treatment targets in RO-DBT: flexibility, receptivity and openness, and true connection. True connection, she is careful to clarify, is not having a large social network. It is the felt experience of being known and loved even in your most uncomfortable truths.
We also discuss emotional loneliness, what Tom Lynch identifies as the core suffering of overcontrolled clients: feeling utterly alone in a room full of people. Dr. Astrachan-Fletcher explains how this loneliness develops from the overcontrolled pattern of masking inner experience and what RO-DBT teaches clients to do differently.
Other topics from this conversation:
The temperament and developmental origins of overcontrol, including the role of threat sensitivity and detail focus in shaping coping early in life. The three mind states in RO-DBT: fixed mind, fatalistic mind, and flexible mind, and how each shows up in session. The clinical presentation differences between emotionally undercontrolled and overcontrolled clients, and how easy it is to misread a controlled client as doing well. Why RO-DBT calls its group component a "class" rather than a group, and what that distinction signals about how overcontrolled clients experience social environments. How RO-DBT is transdiagnostic, reaching across depression, OCPD, restrictive eating disorders, anxiety, and several personality disorders.
Resources Mentioned:
Official RO-DBT Training Site: radicallyopendbt.net
EAF ReCenter (Dr. Astrachan-Fletcher's practice): eaf-recenter.com
RO-DBT for Eating Disorders workbook by Dr. Astrachan-Fletcher
RO-DBT for Anxiety (forthcoming, August 2026) by Dr. Astrachan-Fletcher
Key Points:
00:00 Introduction
03:19 Emotional overcontrol defined
06:51 Overcontrol as the “high road”
09:03 DBT and RO-DBT as dialectics
12:50 Leakage in real life
15:05 Flexibility, openness, true connection
19:49 Social signaling
23:57 Frozen and masked expressions
25:28 Mirror neurons and Botox
28:02 The eyebrow wag
31:29 Self-inquiry and Malamati Sufism
35:38 Self-inquiry meets EMDR
39:14 Mindfulness differences
43:36 Playfulness and teasing
45:35 Screening and self-reporting
50:00 Skills class structure
53:28 Diagnoses that respond to RO-DBT
58:02 Self-care recommendation
Ellen Astrachan-Fletcher is a licensed clinical psychologist, Founder of EAF reCenter, and expert in eating disorders, DBT, and Radically Open DBT (RO-DBT). With nearly three decades of experience spanning academia, clinical leadership, supervision, and training, she specializes in helping individuals cultivate authentic connection and emotional resilience.
Website: https://www.eaf-recenter.com/
LI: https://www.linkedin.com/in/ellen-astrachan-fletcher-ph-d-ceds-s-faed-a2aa8151/?isSelfProfile=false
Lorain Moorehead is a therapist, consultant, and EMDR Certified, EMDRIA‑approved consultant specializing in trauma‑informed care and EMDR integration. She works with high‑achieving adults navigating anxiety, perfectionism, identity loss, and relational stress through depth‑oriented, evidence‑based approaches. Lorain brings advanced training in DBT and certification in Perinatal Mental Health, grounding her work in safety, attunement, and nervous‑system awareness. She also supports clinicians through supervision, consultation, and training, with a strong focus on ethical practice and clinical decision making.
Website: https://lorainmoorehead.com/
LinkedIn: https://www.linkedin.com/in/lorainmoorehead/
Instagram: https://www.instagram.com/theselfcareapist/
TikTok: https://www.tiktok.com/@theselfcareapist
YouTube: https://www.youtube.com/playlist?list=PLjS1AkQopGeVq6eP-1j7Y4i-oloOPSJmw
A short mid-roll CTA inviting listeners to take the Stuck Point Quiz at lorainmoorehead.com/quiz, identify their clinical stuck point, and access personalized resources. Includes an optional invitation to join Lorain’s newsletter.
The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice. With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum here!
If you liked this episode, feel free to subscribe and leave a review! Your support helps us be a top mental health podcast and resource. See you next week!