Here’s the answer: self-judgments have to be made in relation to standards. Those are internalized values, attitudes, ideals, and prohibitions. They are an essential component of the conscience, and their purpose is to keep our behavior in line with family or group expectations using shame and pr...

This year's annual conference of SEPI, the Society for the Explanation of Psychotherapy Integration, was held in Istanbul under my chairmanship. It was energetic. It covered every aspect of psychotherapy. It embodied every point of view. Thoughtful contributions came from around the world. And...

Many of today’s treatment breakthroughs come from an increasingly intimate knowledge of biological processes. The theme of this post is that understanding mental processes can do the same for psychotherapy. Psychodynamic psychotherapy has evolved over more than a century into a broad and subtl...

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...

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...

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...

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...

This post is built on what I often say to adult clients with ADHD. 

ADHD has advantages as well as challenges

We start by countering the negatives about ADHD. This form of neurodiversity comes with definite advantages along with the challenges. The main positives are creativity, hyperfocus, ...