In a recent psychotherapy coaching session, an experienced therapist brought up the problem of a client who seemed to be moving away from the therapy, disengaging. She was afraid he would drop out. In thinking about it, first we applied the consultant’s cardinal rule: “It’s staring you in the ...

What do people naturally do when they don’t feel heard? They get louder. And when that doesn’t work, as it usually doesn’t, they get pushy. “Look, this isn’t that complicated…” And when that doesn’t work, they may get insulting or confrontational. “Are you deaf or just stupid?” It happens in i...

Recently, I was working with clients searching for the antidotes to their troublesome inner truths. We were struggling to find the flaw in those truths. Each one boiled down to the fear that something really bad could happen. The problem was that, while those bad things from the past were not lik...

This post is a look at the incredible variety of ways the inner non-conscious mind seeks to ensure our survival. For some time, I have wanted to try laying out the range of possibilities. This is not the first time anyone has made a list of such strategies, but prominent efforts have been limited...

This post brings material from a pilot training program a group of us have given online for six psychiatric residencies around the country. The subject is one of the two main requirements for memory reconsolidation (MR), the “queen” of change mechanisms because its effects are lasting and effortl...

Lately I’ve been thinking about how our inner “thinking fast” mind interacts with our conscious mind, the one we normally sit in. This has brought into focus the ways my anxious clients dwell on thoughts that serve only to make their bad feelings more intense. I have been calling them “amplifiers...

Today's post is to share a recent experience teaching psychotherapy to psychiatry residents from raw beginners to those with some experience. A group of us from the Psychotherapy Caucus, a special interest group of 1500 psychiatrists within the American Psychiatric Association, developed and pres...

Darwin shocked the world into a new level of humility when he showed that humans aren’t the center of the world but derived from apes. Well, the wave of humility hasn’t quite finished its washing up the beach. The last barrier is consciousness-centrism. I, too, have been guilty of seeing the mind...

In this post, I want to suggest some principles that guide my work with couples as well as how I think about them in individual therapy. These are mostly ideas I haven’t seen in the literature, and I hope they will help to simplify as well as inform the work we do.

First, when I see couples in t...

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I was just interviewed by Jeffrey Magnavita and Jennifer Kelly on modernizing psychotherapy and how to teach it. This is part of a series on "Eminent Psychotherapists" on YouTube. It's my best to date!

Jeffery Smith MD

Writing a book is not just putting down what one knows, it’s a journey of discovery. Chapter 2 of the upcoming How Psychotherapy Works: Navigating the Therapeutic Space with Confidence is about coming to appreciate and even love the inner selves we encounter in our work. The clarity I want to sha...

As chair of the organizing committee I want personally to invite followers of Tuesday Is For Therapists to come to Istanbul, October 10-12, 2025 for an exciting conference focused on foundational principles and processes that cut across multiple therapies. And today, the submission portal is open fo...