Manage episode 514721943 series 3317171
Ever worked hard, did everything “right,” and still felt unseen?
Our conversation with Dr. Ellen Astrachan-Fletcher gets to the heart of why: when control becomes a shield, it also becomes a wall. We dig into Radically Open Dialectical Behavioral Therapy (RODBT) and the hidden costs of over-control—perfectionism, emotional inhibition, and the quiet loneliness of feeling unknown—even in a crowded room
We start with the bell curve of emotional control, where under-control and over-control live at opposite tails. Dr. Astrachan-Fletcher breaks down bio-temperament -- the built-in settings that shape threat and reward sensitivity, detail versus global focus, novelty seeking, and inhibitory control. She shows how these traits steer coping long before we learn clinical “skills.”
If traditional DBT excels as treatment for under-control, RO DBT unlocks the stuck places for over-control by targeting openness, genuine vulnerability, and the social signals that invite connection. You’ll hear how small cues—polished fixes, self-sufficiency, quiet corrections—can accidentally signal superiority or distrust, leaving the most conscientious person out of the celebration.
We also unpack why so many clients cycle through higher levels of care for eating disorders and depression: they stabilize in structured settings, then return to lonely lives without the tools to build a “true connection.” RO DBT reframes feedback as a gift, uses playful teasing to lower perfectionistic armor, and treats social signaling as a change target—not a footnote. Along the way, we discuss ADHD, trauma’s masking effects, self-injury patterns in OC vs. UC, and how culture rewards control while overlooking its costs
If you’ve ever been “the nicest person no one really knows,” this one’s for you. Learn how to move flexibly within your temperament, send warmer social signals, and practice safe vulnerability that actually deepens bonds.
Subscribe, share with a friend who needs it, and leave a review with your biggest “I feel seen” moment—these are great observations to share as they inform others and ourselves.
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Chapters
1. Welcome & Guest Credentials (00:00:00)
2. From Eclectic to DBT to RO DBT (00:01:12)
3. The Bell Curve of Control (00:03:58)
4. Emotional Loneliness and True Connection (00:06:50)
5. Origins of RO DBT with Tom Lynch (00:09:12)
6. Why Over-Control Gets Missed (00:12:10)
7. Biotemperament: Threat vs Reward (00:15:08)
8. Detail Focus vs Global Focus (00:18:05)
9. Novelty Seeking & Inhibitory Control (00:20:36)
10. Self-Injury: OC vs UC Pathways (00:23:05)
11. Biosocial Development of Over-Control (00:25:18)
12. ADHD, Trauma, and Masking (00:27:34)
13. Treatment Priorities in RO DBT (00:29:10)
14. Social Signaling and Isolation (00:31:08)
15. Teasing, Feedback, and Connection (00:34:00)
16. Takeaways & Closing (00:36:20)
75 episodes