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 growth is about creati...

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 seated personality problem. I’ll c...

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 other serious s...

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 followed the path of the Five Key ...

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 psychotherapy. Let’s put aside pat...

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 solver or inner...

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 the specifics of both the threat and t...

“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 and requires a different approach....

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 about h...

Every therapist has their own repertoire of metaphors, rules of thumb, and tricks that come back over and over. I don’t usually share these because I don’t want to bore you, but today I thought our readers, might appreciate a few of the best ones. Here are three.

A blank book with two sides 

Th...

Being right teaches us little, but finding out we got it wrong is exciting and enlightening. Holding an idea one thinks is true, a working hypothesis, then discovering clear evidence that points the other way, can open up new vistas. For many years I have believed (with niggling doubts), that the...

What makes humans so prone to irrational and maladaptive patterns? Entrenched Maladaptive Patterns (EMPs), are products of the human mind. Other mammals have minds, too, that is, a brain that takes in information, identifies threats and opportunities, and generates responses calculated to improve...