I’ve been writing a lot about memory reconsolidation, but perhaps half of the work in my practice is helping people restart psychological development where it was left off. Development doesn’t necessarily involve my favorite change mechanism, memory reconsolidation, because...

Recently I have been involved in situations where someone who could clearly be called “borderline,” was rather suddenly “cured.” In both cases, I had been working with parents and felt the problem was better understood as a developmental issue rather than a deep...

Returning from vacation I’m finding young people and parents rightly concerned about intense and frightening symptoms connected with the demands and stresses of returning to school.They are understandably distressed about severe anxiety, suicidal thoughts, intense compulsions, and...

Linda revealed that the source of her shame was “Penelope,” the name she gave to an inner critic who cut her to shreds for any attempt to live a brighter, more interesting life. In this post, I’ll show how our quest to deepen our understanding and support change...

Most of us light up when we see a small child. That’s how we want to respond to the our own and our clients’ inner selves. I’m afraid I haven’t made that as clear as I would want, especially because that inner child is so often the main character in the drama of...

What has helped me most as a therapist is going beyond diagnosis to work with my patients to deepen our mutual understanding of the patterns causing their suffering. This post is aimed at taking some of the mystery out of those entrenched maladaptive patterns.

Human psychological problems...

Seeking accurate empathy is a good way to create the conditions for change. That is the theme of the Five Key Questions approach to teaching core psychotherapy skills. What it means in practice is putting oneself (and the client’s observing self) in the shoes of the limbic problem...

Unconscious emotion is of central importance for us. It stands at an epicenter between the mind’s appraisal of circumstances and the responses we want to help our clients change. Not only is unconscious emotion a necessary trigger for action, but it embodies...

Why do we need to understand what unconscious emotions a Limbic Protector is “trying” to soften or eliminate? The act of joining with our client to seek this knowledge is an excellent way to create the conditions for change. The Five Key Questions referred to in...

“Where are we and what to do next?” These questions come frequently as we practice psychotherapy, sometimes in the background, but just as often arising as conscious questions. This post is about three very different situations and how each has a different tempo...

This post is adapted from a lecture given given in Marrakech, Morroco, at a conference of the World Association for Dynamic Psychiatry and the World Federation for Psychotherapy on 4/16/2024.

Introduction: Modernizing the teaching and practice of psychotherapy

A worldwide need for...

My first experience of memory reconsolidation (MR) was dramatic, so much so that it triggered a career-long drive to understand therapeutic action. But I was not alone, nor the first. The same remarkable phenomenon was the beginning of psychotherapy as we know it.

When. Breuer told Freud...