Psychofarm Podcast

Dr. Catherine Eubanks, PhD joins us to unpack the therapeutic alliance in everyday practice: how to spot withdrawal and confrontation ruptures, why Bordin’s goals–tasks–bond still predicts outcomes, and how metacommunication jump starts repair. We translate research into concrete moves you can use in brief psychiatric visits, psychotherapy, and supervision. We discuss telehealth, boundaries, and measuring ruptures with the 3RS system. Clinicians, trainees, and curious listeners will leave with a clearer lens and usable language for repair that strengthens trust and improves care across settings.Upcoming WorkshopAlliance Rupture Repair with Dr. J. Christopher Muran & Dr. Catherine EubanksWhen: Thursday, November 13 (1:00–4:00 PM EST)Where: Virtual via ZoomCost: $60 CE | $50 General | Students 50% off (code: STU)CEs: APA for psychologists; NYSED for LCAT, LCSW, and clinical psychologistsDescription:A 3-hour transtheoretical workshop on recognizing and repairing alliance ruptures. Includes didactics, video analysis, and skills training to improve repair strategies and strengthen therapeutic effectiveness.Register: https://www.eventbrite.com/e/alliance-rupture-repair-3-ces-tickets-1797546502979?aff=oddtdtcreatorRecommended Books & VideosTherapist Performance Under Pressure: Negotiating Emotion, Difference, and Ruptureby Catherine Eubanks & J. Christopher Muranhttps://www.apa.org/pubs/books/therapist-performance-under-pressureRupture and Repair in Psychotherapy: A Critical Process for Changeedited by J. Christopher Muran, Catherine Eubanks, & Lisa Wallner Samstaghttps://www.apa.org/pubs/books/rupture-repair-psychotherapyVideo: Rupture and Repair in Psychotherapyhttps://www.apa.org/pubs/videos/rupture-repair-psychotherapyAlliance-Focused Training: An Evidence-Based Guide to Negotiating Ruptures in Therapyby J. Christopher Muran, Catherine Eubanks, Lisa Wallner Samstag, & James Macdonaldhttps://www.apa.org/pubs/books/alliance-focused-trainingaVideo: Using Alliance-Focused Traininghttps://www.apa.org/pubs/videos/using-alliance-focused-training This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Why does it feel like everyone thinks they have ADHD lately? In this episode, two psychiatrists discuss the differential of ADHD. They explore how social media trends (like viral TikTok videos) are fueling ADHD self-diagnosis, and they emphasize the importance of careful evaluation. You’ll learn how to think through whether it’s ADHD vs. look-alike conditions such as depression, anxiety, trauma, OCD, sleep deprivation, or even just chronic stress and burnout. The doctors also talk about the burnout mental health providers are facing with so many people seeking ADHD meds, and they share their balanced approach to diagnosing and treating attention issues in an evidence-based way. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Gregory Malzberg, a psychiatrist and author renowned for his practical guides on antidepressant management, dives into the enduring relevance of psychoanalysis in today's psychiatry. He explores major schools of psychoanalytic thought, emphasizing the need for clarity in terminology and practice. The conversation highlights how understanding personality and attachment theories can enhance treatment, especially for complex cases. With insights on the interplay of psychoanalytic concepts and modern medication management, Malzberg defends the value of observational knowledge in clinical settings.

In this episode, we dive into the complexities of the therapeutic alliance and the real challenges psychiatrists face in everyday practice. From patients insisting on ADHD diagnoses and stimulant prescriptions to those requesting Xanax, disability paperwork, or resisting involuntary admission, we role play common clinical encounters and discuss practical strategies for navigating them. Drawing on concepts like collaboration and alliance, we highlight tools for psychiatrists, therapists, and clinicians to manage difficult conversations without burning out. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

In this episode we break down how to run a focused, humane, and evidence informed psychiatric intake. We start with setting the frame and role clarity, then show how to use a free narrative to map life course symptoms before moving into targeted history, DSM-5 criteria, and the mental status exam. Along the way we tackle common requests for ADHD or autism evaluations, the risks of checklist thinking, and when to pivot to structured tools. We close with communicating impressions, treatment planning, and next steps. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Boundaries aren’t just rules in psychiatry… they’re part of the treatment itself. In this episode, we explore therapeutic ruptures, transference and countertransference, and how clear treatment frames protect patients, clinicians, and the therapeutic process. From handling “doorknob comments” to navigating burnout, we highlight the practical ways psychiatrists and therapists can use boundaries to strengthen care and reduce resentment. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

In this episode, we examine the complex phenomenon of erotic transference in psychiatric care and the critical role of maintaining ethical boundaries. Using the therapeutic frame as our guide, we unpack how patients may develop romantic or sexual feelings toward their psychiatrist… especially during medication management… and why strong boundaries and reality testing are essential to safeguard the treatment process. Drawing on clinical experience and ethical principles, this episode offers clinicians strategies for addressing counter-transference, reinforcing the therapeutic alliance, and knowing when referral or supervision is necessary to protect both patient welfare and professional integrity. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Discover the intricacies of treating OCD with a focus on medication strategies like SSRIs, clomipramine, and the promising role of N-acetylcysteine. Learn about the significance of exposure response prevention and how alternative approaches like TMS can aid in symptom management. The discussion delves into the complexities of OCD diagnosis and the potential pitfalls of treatment, emphasizing personalized care. Unpack the fascinating role of the Sigma-1 receptor in medication effectiveness and explore new therapeutic methods to enhance patient outcomes.

In the pilot episode of You Tell Me, the hosts dive into the controversial question: “What’s the harm in more widespread stimulant use?” They explore Silicon Valley’s productivity culture, stimulant risks, and the ethical dilemma of turning psychiatry into a tool for optimization. From there, the conversation shifts into a lighter segment on the stereotypes of medical specialties. The episode ends with a candid discussion on trauma, codependency, and why inpatient psychiatry often misses the mark.This off-the-cuff episode blends unfiltered opinions with occasional psychiatric insights… approachable for clinicians, medical students, or anyone curious about the culture of modern psychiatry. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit psychofarm.substack.com

Dive into the complex world of Obsessive Compulsive Disorder as the hosts unpack its DSM-5 criteria and the challenges in diagnosing it. They explore the neurobiological roots behind compulsive behaviors, drawing parallels with addiction. The importance of Exposure and Response Prevention (ERP) is emphasized, alongside effective medication strategies. Personal anecdotes add depth, shedding light on the nuances of OCD while providing practical guidance for clinicians and individuals alike.