Self Careapist Therapist: Expert Insights & Practical Therapy Skills

What can interracial couples teach therapists about race, family systems, and the conversations many clients are still learning how to have?

In this episode of The Self Careapist Therapist, I sit down with Dr. Geoffrey Greif and Victoria D. Stubbs, LCSW, co-authors of Interracial Marriage: How Diverse Couples Navigate Relationships. We talk about what hundreds of interviews with interracial and interethnic couples revealed about communication, family approval, identity, power, children, language, safety, and the daily accommodations many couples learn to make.

We also explore how therapists can approach these conversations with more humility, curiosity, and clinical nuance. Victoria shares how the six pillars of a brave space framework can support conversations about race, power, privilege, oppression, and identity, while Geoffrey highlights what research interviews can reveal that surveys often miss.

Listen to this episode of Interracial Marriage: Love, Identity, and Navigating Differences with Geoffrey Greif and Victoria D. Stubbs

Dr. Geoffrey Greif is a professor at the University of Maryland School of Social Work, researcher, author, and co-author of Interracial Marriage: How Diverse Couples Navigate Relationships. His work spans family relationships, fathers, adult sibling relationships, group work, and interracial marriage research.

Website: https://geoffreygreifbooks.com

Victoria D. Stubbs is the founder of Inner Truth Psychotherapy and Wellness, co-author of Interracial Marriage: How Diverse Couples Navigate Relationships and was previously a full-time clinical instructor at the University of Maryland School of Social Work. 

Website: https://www.innertruthllc.com/

Instagram: https://www.instagram.com/innertruthllc/

Discover how love transcends boundaries — click the link to grab your copy of Interracial Marriage: How Diverse Couples Navigate Relationships in a Divided Time and explore the powerful, real stories that remind us that connection is stronger than division! 

Buy the Book Here: https://www.amazon.com/Interracial-Marriage-Diverse-Navigate-Relationships/dp/0231218192

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 decisionmaking. In 2025, she launched The Self Care‑apist Therapist Podcast, creating space for therapists to explore innovative, research‑backed modalities—including emerging conversations around KAP and trauma treatment.

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  

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

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  

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

Moments of hesitation after a first EMDR session often signal that meaningful work has already begun.  

In this episode of The Self Careapist Therapist, I break down what’s really happening when clients feel unsure about continuing EMDR after their first session. I walk through common reactions like exhaustion, vivid dreams, confusion, and the sense that something shifted without fully understanding why. 

I also talk about how to respond clinically. Sometimes it’s about better debriefing and helping clients understand what their brain is doing.

In some cases, hesitation points to something deeper. Slowing down, strengthening safety, and meeting the client where they are can make the difference between dropout and meaningful progress.

Let this episode sharpen how you interpret hesitation in your clients. Watch now Why Clients Skip Their Second EMDR Session (And What It's Telling You).

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 decisionmaking. In 2025, she launched The Self Care‑apist Therapist Podcast, creating space for therapists to explore innovative, research‑backed modalities—including emerging conversations around KAP and trauma treatment.

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  

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

What does it actually mean to practice ACT — and how would you know if you already are? Dr. Steven C. Hayes, the originator of acceptance and commitment therapy, joins the podcast to talk about the 45-year arc of ACT's development, where the field of psychotherapy has gone wrong, and what it would mean to truly serve the person sitting in front of you. This conversation covers the six core processes of psychological flexibility, why randomized controlled trials may be misleading your clinical work, and why Dr. Hayes thinks every therapist should start by trying ACT on themselves. If you have been ACT-curious, or if you have been using elements of it without naming it, this episode gives you the bones.

Episode Timestamps

0:00 — Introduction

1:27 — What ACT is, and why it may already be in your practice

2:41 — ACT in a single sentence: open, aware, and actively engaged

4:48 — The origin story: personal suffering, panic disorder, and the limits of existing evidence-based therapy

8:08 — Did ACT precede DBT? Dr. Hayes on Marsha Linehan and the shared roots of third-wave approaches

10:35 — Process-based therapy: why the technique matters less than the mechanism

13:29 — What to do instead of drawing a fence around your modality

21:27 — The six core processes of psychological flexibility, explained one by one

29:32 — Reaching more people: how ACT is being used in lower- and middle-income countries

33:28 — Why your journal articles may be statistically misleading you (the ergodic theorem)

38:30 — Idiographic measurement: tracking the individual, not the aggregate

43:00 — PsychFlex and the Personalized Life Assessment Network: tools you can use now

48:51 — The eugenics roots of standard statistical methods in psychology

52:29 — The neurodiversity movement and what it gets right

56:00 — Outcome measurement that fits the actual person

1:01:35 — Where ACT is going: empowering clinicians from the bottom up

Episode Highlights

• ACT is not a set of techniques. It is a model built around processes of change — the small, repeatable behaviors that lift people up or push them down. A new randomized trial is published on ACT every two days.
• Psychological flexibility — learning to be more open, aware, and actively engaged in meaningful life — is the core target of ACT. Dr. Hayes argues it is also the mediating mechanism behind DBT, MBCT, and most other third-wave approaches.
• The six core processes of ACT are organized around three pairs: openness (cognitive defusion and acceptance), awareness (flexible attention and a transcendent sense of self), and engagement (values and committed action). They are not six separate things — they work as a system.
• The statistical methods clinicians rely on — Pearson's R, analysis of variance, factor analysis — were developed by eugenicists and assume that differences between people predict any individual's future. The ergodic theorem, proven in the 1930s, demonstrates mathematically that this assumption is false.
• Process-based therapy means starting with the person in front of you, identifying which processes are lifting them up or pushing them down, and choosing methods that move those processes. The label you attach to it matters less than whether it works for that person.
• Dr. Hayes recommends two starting points for clinicians: (1) do a perceived causal network with your client — map what matters, what helps, what hurts — and (2) track those nodes over time with a small number of personalized items. He has been doing this with himself for years.
• ACT has more randomized trials from lower- and middle-income countries than any other psychotherapy model. Dr. Hayes attributes this to the process-based approach: when clinicians are empowered to apply principles in their own cultural language, the framework travels.

Resource

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

What happens when a therapist takes EMDR training, loves the eye movements, and throws out the protocol entirely? Laney Rosenzweig did exactly that. In 2007, she walked out of an EMDR training room convinced there was a better way. Eighteen years later, ART (Accelerated Resolution Therapy) has been trained at military bases, studied at Mayo Clinic and Yale, and is resolving complex trauma in a single session. Laney joins the show to break down how ART works, who it helps, and what the training path looks like for licensed clinicians.

Episode Timestamps

•       0:38 - The origin story of ART

•       9:27 - Modifications since the stroke and continued dedication

•       10:14 - Commonalities between ART and EMDR origins

•       11:48 - Eye movements vs. other bilateral stimulation methods

•       13:45 - Positization and the role of humor in ART

•       15:32 - The ART script and how it restructures trauma

•       17:14 - ART training at military bases and Walter Reed

•       18:33 - ART as a foundational model vs. EMDR

•       19:24 - Free association vs. guided protocol

•       22:56 - How to set expectations with new ART clients

•       24:25 - The role of metaphor in ART

•       26:23 - Staying passionate after decades of clinical work

•       28:30 - What to expect from the basic three-day training

•       31:43 - Practicum structure and the three-to-one ratio

•       33:25 - Advanced training and credentialing pathway

•       36:09 - Who is not a candidate for ART

•       37:19 - How to explain ART to a new client

•       39:56 - Working with children and the SAFT technique

•       42:53 - Training licensed therapists and ethical considerations

•       44:30 - Becoming an ART trainer

•       47:36 - How ART grew through word of mouth and research

•       54:03 - Free intro sessions and getting started

•       58:12 - Self-care through ART

Episode Highlights

•       ART was developed after Laney found EMDR's free association protocol too unpredictable. By placing eye movements directly on the problem and building in a structured end point, she created a model that consistently resolves trauma in one session.

•       The core mechanism is image rescripting combined with eye movements. Rather than asking clients to free associate, the ART script guides the brain to replace distressing images with positive ones, which Laney calls positization.

•       Humor is a deliberate part of the ART approach. Laney gave the example of a palmetto bug phobia transformed into a favorable image of Willie Nelson. When clients can bring lightness to a previously terrifying image, the therapeutic shift has taken hold.

•       Metaphor is built into the model, not added as an option. The brain processes in images during sleep, and ART mirrors that process. Clients who resist direct confrontation of a trauma can work entirely through metaphor, including a structured script for clients who fear change.

•       ART is not free association. Unlike EMDR, the therapist guides the protocol from start to finish. Clients know what to expect and sessions have a clear endpoint, which Laney found critical for both therapist confidence and client safety.

•       The three-day basic training

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

Can Flash technique fully and permanently resolve a trauma memory in a single session, with almost no distress, even in clients with complex PTSD? Thomas Zimmerman has been answering that question for four and a half years, and his answer is yes. In this episode, he walks through the science, the structure, and the live protocol of the Predictive Processing Flash technique (formerly Four Blinks Version of Flash), with me as the client.

Thomas is a mental health therapist, EMDR consultant, author, podcaster, and trainer based in Cleveland, Ohio. He developed his version of the Flash technique, originally called Four Blinks, around a predictive mind model of the brain. He explains why that model changes how we understand trauma, memory, and healing, and why it means every client is capable of change.

We cover the four resourcing tools that make this approach safe for complex presentations, how Flash differs from EMDR in every structural and theoretical way, and what is actually happening in the nervous system during a session. Then we do a live demo. I work through a real memory in real time.

Thomas also offers free Flash trainings every two weeks, free bi-monthly consultation, and a free weekly self-care Flash group for trained clinicians. This is a conversation worth sharing with every trauma-focused colleague in your network.

Resources: https://emdrwithcomplextrauma.com/, https://thomaszimmerman.us/, https://emdrcleveland.com/

1:00 - Thomas's background: 10 careers, trauma work, and finding Flash

3:10 - From CBT to EMDR to Flash, and why each mattered

5:32 - Watching 70 consecutive clients resolve trauma without significant distress

6:29 - Flash is not a resource. How Zimmerman changed his understanding

8:29 - The working mechanism: how Flash actually resolves memory

9:20 - Why Zimmerman moved away from the triune brain model

11:28 - The predictive mind model: predictions, error, and precision weighting

14:07 - Why effective trauma approaches feel culturally non-intuitive

19:00 - Demo setup: orienting to what Flash asks you to do

20:25 - Resource 1: Container

22:09 - Resource 2: Shop Vac

26:17 - Resource 3: Pleasant (Calm) Scene

28:44 - Resource 4: Sensory Grounding

34:06 - Selecting the memory and setting up the live demo

37:34 - The Flash demo begins

44:22 - The memory resolves: checking for distress on all channels

47:06 - The positive cognition that installed on its own

51:41 - Neurobiological debrief: what just happened in the predictive mind

58:18 - Free Flash trainings, consultation, and the weekly therapist self-care group

59:49 - Why Thomas offers all of this at no charge

1:02:43 - Thomas's book and the metaphorical index

1:05:19 - Self-care: what Flash has done for Thomas personally

Episode Highlights

• Flash technique fully and permanently resolves trauma memories, not just reduces distress before EMDR. Zimmerman watched 70 consecutive clients complete full adaptive resolution before he changed how he understood the modality.

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

What if the most common sticking points in EMDR therapy have clear, evidence-informed answers? In this solo episode, Lorain Moorehead, LCSW draws directly from her EMDR consultations with therapists to answer five questions that come up again and again in clinical practice. From understanding adaptive information processing and the eight-stage EMDR protocol to navigating negative cognitions, assessing dual awareness, and knowing when to adjust bilateral stimulation, this episode is a practical resource for therapists at every stage of their EMDR training and practice. Whether you are newly trained or a seasoned EMDR therapist, this episode will sharpen how you approach your next session.

0:00 - Intro

1:15 - How adaptive information processing works

2:29 - How trauma generalizes across situations

4:30 - The eight-stage EMDR protocol

6:16 - Resourcing and dual awareness

8:20 - Signs a client needs more resourcing

10:20 - Building the trauma timeline: first, worst, and most recent

13:00 - Virtual EMDR and eye movements vs. other bilateral stimulation

16:00 - Negative cognitions and linked trauma targets

18:11 - Why negative cognitions are hard to identify

20:16 - Criteria for a strong negative cognition

22:38 - Belief vs. fact: an important distinction

24:32 - The gut punch test for the right NC

26:42 - When a client is stuck in reprocessing

28:29 - Adjusting BLS length and speed

30:44 - Combining bilateral stimulation modalities

Episode Highlights:

Adaptive information processing is the theory underlying EMDR. The brain has a natural capacity to process experience, but trauma disrupts that process, and what begins as one trigger can generalize to many situations over time.

EMDR is an eight-stage protocol, and the reprocessing portion is only one part of it. The work has already begun long before bilateral stimulation starts.

Assessing dual awareness, the ability to hold one foot in the present and one foot in the past, is one of the most important readiness indicators before moving into reprocessing.

Spending multiple sessions on resourcing is not a delay. It builds the capacity for clients to visit difficult material and return to the present moment without destabilizing.

The trauma timeline does not need to be exhaustive. Focusing on the first, worst, and most recent incidents is enough to identify the full scope of a target without unnecessarily retraumatizing clients in the process.

Eye movements tend to be the most effective form of bilateral stimulation for many clients, and virtual EMDR can be just as productive as in-person sessions when set up thoughtfully.

A negative cognition must be about the self, negative rather than neutral, a belief and not a fact, and felt as present-tense relevant in order to carry the weight needed for reprocessing to move.

Negative cognitions are often shaped in childhood and can persist even when the adult brain understands the situation differently on a logical level. The NC connects with the instinctual layer of belief, not the reasoning one.

Continuing Education: 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.

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

What if mindfulness is not a homework assignment you give clients, but the thread running through every single clinical decision you make? In this episode of Self Careapist Therapist, I sit down with Dr. Nikki Rubin, licensed clinical psychologist, ACT specialist, assistant clinical professor at UCLA, and co-founder and COO of Mind Science Collective, a continuing education platform built by clinicians for clinicians. We trace the full history of cognitive behavioral therapies from first wave behaviorism through second wave cognitive interventions to the third wave approaches that define evidence-based practice today, including ACT, DBT, and CFT. Dr. Rubin breaks down how mindfulness functions as a core behavioral tool in the therapy room, how it connects to clinical intuition, and how to help clients distinguish between what their gut is really telling them versus what anxiety is projecting. We also dig into behavioral case formulation, the entrepreneurial path in private practice, and what it looks like to build a values-driven continuing education business. Stay until the end for a live guided mindfulness exercise, and use code SELFCAREAPIST10 at checkout for 10% off any MindScience Collective course.

0:00 - Intro

1:27 - How Dr. Rubin's passion for teaching and training clinicians began

4:48 - The founding of Mind Science Collective and what it offers

10:33 - How CE courses work and the range of topics available

13:18 - ACT values, creativity, and what drives the entrepreneurial instinct

13:38 - The history of CBT waves from Skinner to the third wave

18:06 - What might come after the third wave

21:09 - Reframing the therapist's relationship to marketing and business

27:22 - How mindfulness functions as the foundation of every clinical intervention

29:55 - A clinical example of moment-to-moment mindfulness with a patient

32:28 - Live guided mindfulness exercise with Dr. Rubin

37:12 - Processing the exercise and debunking myths about mindfulness

41:00 - The link between mindfulness and clinical intuition

43:35 - Distinguishing intuition from anxiety in session and in life

47:45 - Upcoming course: The Science of Intuition

48:27 - Supervision training and its parallels with behavioral case formulation

50:27 - What clinicians most commonly miss in case formulation

54:03 - Mindfulness as a thread across theoretical orientations

56:24 - Dr. Rubin's personal approach to self-care

Episode Highlights:

Mindfulness is a core behavioral practice that threads through every clinical intervention, from conceptualization to treatment planning to in-session responses, and carries far more clinical utility than assigning meditation as homework.

Third wave CBT therapies, including ACT, DBT, and CFT, emerged in the mid-1980s through a formal integration of acceptance-based and mindfulness-based practices alongside second wave cognitive techniques.

ACT values extend beyond the therapy room into professional decisions, entrepreneurial endeavors, and how clinicians approach their own continuing education and growth.

Mindfulness is not about clearing the mind. It is about paying present-moment attention while the brain does exactly what it is designed to do, which is generate thoughts, get distracted, and generate distraction again.

Mindfulness and intuition are deeply linked. Mindfulness creates the space needed to quiet mental noise so that what intuition is communicating can actually be heard.

Intuition is not premonition. It is a synthesis of all available data up to this moment, and it requires practiced mindful awareness to distinguish it from 

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

What if perfectionism has nothing to do with wanting things done well? Dr. Paul L. Hewitt, Full Professor of Psychology at the University of British Columbia, researcher, and co-author of Perfectionism: A Relational Approach to Conceptualization, Assessment, and Treatment, joins the podcast to reframe perfectionism as a deeply relational personality style born out of unmet attachment needs. This conversation covers the development of perfectionism through early relational asynchrony, how it functions differently from conscientiousness or high standards, what Dynamic-Relational Therapy for Perfectionism looks like in practice, and what clinicians should know about the depth of pain underneath a high-functioning exterior. The episode also covers new research on how perfectionism in therapists affects the therapeutic alliance.

0:00 - Intro and Dr. Hewitt's background

0:54 - How a dentist's waiting room started a research career

2:30 - Personal connection to perfectionism through classical music training

3:17 - Defining perfectionism as a personality style rather than a set of attitudes

4:03 - The unmet relational and esteem needs underneath perfectionism

8:18 - Whether perfectionism concentrates in one area or crosses all life domains

11:55 - Why achievement fails to correct the core wound (case example)

14:06 - Links to attachment theory and early developmental asynchrony

22:51 - Perfectionism in high-achieving professionals and entrepreneurs

27:20 - The wrong tool: an elegant but ultimately childlike solution to deep pain

28:21 - How treatment parallels the challenge of exposure work in OCD

30:56 - Distinguishing clinical perfectionism from conscientiousness and high standards

32:20 - The vulnerability piece: procrastination and never getting started

33:35 - Dr. Hewitt's concerns about symptom-based classification systems

36:14 - What typically brings someone to therapy for perfectionism

38:29 - The tenets of Dynamic-Relational Therapy for Perfectionism

40:54 - How the therapeutic relationship becomes the vehicle for change

42:37 - Treatment length and the 30-session research benchmark

43:46 - The clinician workshop training model explained

54:24 - The perfectionism book and the new paperback edition

57:38 - The depth of pain underneath high-functioning clients

59:44 - Concealment, imposter syndrome, and the hidden self

1:01:00 - Research on perfectionism in therapists and its impact on the alliance

Episode Highlights:

Perfectionism is a layered, complex personality style rooted in unmet needs for love, acceptance, and personal worth, not a drive for high standards.

The core dynamic is a deeply human need to feel acceptable to others and worthy as a self, which perfectionism attempts to solve through a strategy that can never deliver what it promises.

Perfectionism develops through early attachment asynchrony, where the child's needs are not adequately met and they learn that appearing perfect may be the path to safety and connection.

Striving for excellence and perfectionism are meaningfully different. The key clinical signal is whether achievement produces any lasting impact on the person's sense of self.

Perfectionism is less about trying to be perfect and more about ensuring one is never exposed as imperfect, making the fear of imperfection the central organizing force.

Dynamic-Relational Therapy for Perfectionism targets the underlying relational needs rather than perfectionism behaviors themselve

Continuing Education: Many episodes offer a free CEU for licensure in Arizona through the Board of

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.

What happens when two EMDR practitioners who trained together start comparing notes on ketamine? Amanda Baker, LCSW, a clinical social worker at Mindful Springs Counseling in Colorado Springs, joins the conversation to break down ketamine-assisted psychotherapy from the ground up. We explore the striking overlap in neural mechanisms between ketamine and EMDR, walk through the preparation and integration framework, and discuss the virtual group model Amanda ran to make CAP more accessible. She also addresses safety, contraindications, the prescriber relationship, what the training landscape looks like for therapists who want to get started, and why the answer to helping people is rarely about holding on to every client.

0:00 - Intro and Amanda's background

1:21 - Amanda's varied social work career and path to therapy

3:07 - Arrival at Mindful Springs and first exposure to ketamine

5:06 - EMDR training origins and how both modalities connect

9:28 - Moving past skepticism about psychedelics

12:24 - The neural mechanism behind ketamine and how it mirrors EMDR

14:13 - Types of ketamine delivery methods explained

18:00 - What preparation and integration look like in practice

24:21 - Building partnerships with prescribers

28:10 - The virtual ketamine group model

33:08 - The role of chaperones and reparative attachment

34:04 - Conditions the research supports treating with CAP

35:44 - Safety, contraindications, and the high-profile misuse case

40:37 - The history of psychedelics and ketamine's pharmaceutical origins

46:27 - Training resources and how to get started

49:51 - The social work mindset and connecting clients to the right provider

53:32 - Amanda's self-care and ethics-based consultation practice

Episode Highlights:

Ketamine and EMDR appear to share a neural mechanism, both promoting new neural development and activating overlapping brain regions associated with relaxation and healing.

The types of ketamine treatment range from IV infusion and intramuscular injection to oral lozenges and esketamine nasal spray, with differing levels of psychedelic intensity and varying degrees of therapist involvement.

Preparation and integration are not optional steps surrounding the dosing session. They are the therapeutic architecture that makes the experience meaningful and the outcomes lasting.

A 24 to 48 hour window after a dosing session is the most active period for neural growth and integration, making timely follow-up a clinical priority.

Low-dose psycholytic ketamine keeps clients alert and conversational, making it highly compatible with active therapeutic work during the session itself.

A prescriber who is willing to write a prescription without speaking with the treating therapist first is a significant red flag.

Contraindications include active psychosis or schizoaffective conditions, unregulated hypertension or thyroid disorders, significant cardiac irregularities, and pronounced rigid personality disorder features.

The virtual group ketamine model supported four clients at a time through preparation, dosing, and integration, increasing accessibility by reducing individual session costs.

The chaperone role during dosing sessions carries potential for reparative attachment, as clients often choose someone close to them who then shows up in a way the client may not have previously experienced.

Training resources include Journey Clinical and Fluence, IPI, and Proddy; Sunny Strasburg's Panther model connects the EMDR eight phases directly to the CAP treatment structure.

Website:

Not sure where you're stuck clinically? Take the free Stuck Point Quiz at lorainmoorehead.com/quiz and get resources matched to your answers.

Self Careapist Therapist Podcast is a biweekly, therapist-to-therapist conversation hosted by Lorain Moorehead, LCSW, PMH-C, EMDRIA Approved Consultant. Guests include psychologists, researchers, and the developers of the clinical models they teach, with practical takeaways for every level, from intern to clinical supervisor. Many episodes offer a free CEU for Arizona licensure through the Board of Behavioral Health Examiners.

New episodes every other Wednesday. If this episode was useful, leave a review on Apple Podcasts. It helps other therapists find the show.