
Psychofarm Podcast
PsychoFarm Podcast is a deep dive into the intersection of psychiatry, psychopharmacology, and the evolving understanding of mental health. Hosted by 2 psychiatrists, the podcast explores complex topics such as diagnosing mood and personality disorders, the role of medications in treatment, and the challenges of psychiatric training. Each episode breaks down the clinical insights and philosophical debates surrounding mental health care, providing both practitioners and curious listeners with thoughtful analysis, expert opinions, and practical advice. psychofarm.substack.com
Latest episodes

Jan 29, 2025 • 1h 10min
Probably The Most Important Topic in Psychiatry: Therapeutic Alliance and Frame
Explore the fundamentals of the Therapeutic Alliance and Frame in this podcast episode, where we highlight how trust, clear communication, and structured boundaries form the bedrock of effective psychiatric practice. Learn practical strategies for aligning treatment goals, clarifying diagnostic expectations, and navigating challenges like medication hesitancy or “trauma dumping.” Perfect for psychiatrists, therapists, and mental health enthusiasts, this discussion offers real-world examples, expert insights, and actionable tips to build a more collaborative and successful therapeutic relationship. 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

Jan 15, 2025 • 58min
The Best Bipolar Medication Review From The Best Bipolar Expert
Humbly…. we explore a practical overview of bipolar disorder, from refining your diagnostic approach to navigating effective treatments. In this episode, we highlight how sleep patterns play a pivotal role, how substances and antidepressants can complicate clinical presentations, and the fundamentals of evidence-based medication choices, spanning mood stabilizers and second-generation antipsychotics. Discover best practices for acute mania management, bipolar depression strategies, and why lifestyle interventions are crucial for long-term stability. Whether you’re a seasoned clinician or just starting out, this conversation offers valuable insights on delivering comprehensive, balanced care for individuals with bipolar disorder. 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

Jan 6, 2025 • 1h 12min
Treating Depression: Practical Tips & Pearls for Anti-Depressant Medications
This episode delves into the pearls of treating depression with medications, offering practical strategies for clinicians and patients alike. From identifying the root causes of depressive symptoms to exploring evidence-based medication and lifestyle interventions, this discussion provides actionable insights for improving mental health outcomes. Learn about personalized treatment options, managing side effects, and the importance of a strong therapeutic alliance in achieving sustained remission. 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

Dec 17, 2024 • 1h 1min
Understanding Borderline Personality Disorder with Dr. Mark L. Ruffalo
Join renowned therapist Dr. Mark Ruffalo as he unpacks the complexities of Borderline Personality Disorder (BPD). This discussion delves into the relational patterns, effective communication of diagnoses, core anxieties, and the need-fear dilemma. Whether you're a mental health professional or someone seeking understanding, Dr. Ruffalo provides invaluable insights. 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

Dec 4, 2024 • 1h 14min
Insomnia and Sleep Medications in Psychiatry
In this episode, we dive into the use of sleep medications in psychiatry. Is insomnia a standalone condition or a symptom of deeper issues? We discuss our clinical approach to treating sleep disturbances in psychiatric patients, focusing on medications to the nuanced use of trazodone, gabapentin, and antihistamines. Along the way, we explore the intersections of sleep and psychiatric illnesses, and the role of medications in patient recovery. 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

Nov 26, 2024 • 53min
Nancy McWilliams on Psychoanalytic Diagnoses, Part 2: Depressive Personality, Histrionic Personality, OCPD
In part two of our conversation with Dr. Nancy McWilliams, we explore a diverse range of personality dynamics, from the socially expressive yet vulnerable histrionic style to the introspective and reserved schizoid personality. Dr. McWilliams offers unique insights into how cultural and social contexts shape personality types, especially the often misunderstood histrionic style, which she discusses from her own personal perspective. We also examine the attraction between histrionic and schizoid personalities, uncovering the push-pull dynamics that can both challenge and enrich these relationships. Rounding out the discussion, we turn to obsessive-compulsive personality, investigating its roots in control, morality, and perfectionism and differentiating it from clinical OCD. With practical tips for therapists, along with reflections on the importance of countertransference and empathy, this episode provides a rich, thoughtful journey into the diverse landscape of personality.One Fall on Spotify: 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

Nov 18, 2024 • 1h 14min
Psychosis: History, Delusions, Diagnosis, Theories, and Modern Care
We explore the evolution of psychosis diagnoses from the early DSM days to modern psychiatry, unpack the role of language in shaping delusions, and discuss how treatment has (and hasn’t) progressed. From Lacanian theories to real-world clinical challenges, this episode bridges the gap between theory and practice while tackling stigma head-on. Perfect for clinicians, patients, and anyone curious about the mind’s mysteries. 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

Nov 13, 2024 • 1h 1min
Nancy McWilliams on Psychoanalytic Diagnoses, Part 1: Personality, Defenses, Themes, Paranoid Personality
In this episode, Dr. Nancy McWilliams explores the foundations of personality, tracing how our unique defenses and core life themes shape who we are and how we relate to others. She discusses the concept of personality as a tapestry woven from central themes rather than fixed traits, revealing how these themes serve as guiding narratives that influence our behaviors and relationships. The conversation takes a deep dive into the paranoid personality style, examining its key features of trust, betrayal, and sensitivity to perceived threats. Dr. McWilliams also discusses how early life experiences and family dynamics can lead individuals to develop certain defenses—particularly the powerful defenses found in paranoid personalities, such as projection and splitting. With her characteristic empathy, Dr. McWilliams shares insights on the therapeutic approaches that help individuals find greater balance and self-understanding, offering listeners a fresh perspective on the complexity and humanity behind personality and defense mechanisms. 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

Oct 22, 2024 • 32min
Healthy Personality Traits, Trauma vs. Personality, and Why Trauma Doesn’t Explain It All
This episode is a continuation of our previous conversation on personality. We dive deep into the complex world of personality disorders and healthy personality traits. From the misconceptions that plague psychiatric diagnoses to the often-overlooked truths about how we develop emotionally… We discuss the difference between normal development and personality disorders, discuss the stigma surrounding diagnoses like borderline personality disorder, and explore how trauma shapes our sense of self, but doesn’t quite explain everything. 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

Oct 14, 2024 • 40min
What Psychiatrists Get Wrong About Personality Disorders
Delve into the complex world of personality disorders and discover common misconceptions that plague diagnoses. The discussion critiques traditional frameworks, advocating for a more integrative approach to understanding personality development. Explore the limitations of OCEAN traits and how they fall short in interpreting individual behaviors. Rethink psychopathy and personality disorders while gaining insights on the differences between OCD and OCPD, focusing on emotional experiences and their impact on relationships. It's a fresh take on psychological intricacies!