Tuesday is for Therapists: Biweekly Essays

TIFT #76: Adolescent and Adult Immaturity Isn't In the DSM tift May 23, 2023

One of the most troubling aspects of mental health treatment currently is the tendency to treat diagnoses instead of people. In the meantime we have a mental health crisis among teens and young adults where far too often, the underlying problem is developmental arrest, which isn’t...

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TIFT #75: Reclaiming Lost Power tift Apr 25, 2023

 

A common clinical problem is the adult client who finds him or herself repeatedly overpowered by others. In this post, I’m sharing some thoughts about what we, as therapists, can do to help.

Choosing between survival and power

From TIFT #72, I want to repeat two points. First,...

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TIFT #74: How We Make Clinical Decisions tift Apr 11, 2023

 

Teaching a class of trainees and early career therapists got me to thinking about the question of clinical decision making. My co-leader shared the example of a client asking, “If you were in my position, what would you do?” I counted six ways a clinician might make such a...

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TIFT #73: The Other Side of Stress tift Mar 28, 2023

Many of us, myself included, have tended to think of stress and relaxation as opposing forces. This post is about a different way to look at them, as two stages in a natural cycle. What makes recognition of the cycle important is that, in humans, it can be held in semi-permanent suspension.

We...

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TIFT #72: Dignity tift Mar 14, 2023

 

For us therapists, the most interesting thing about dignity is that it should be a right, but it can be given, taken away, demanded, defended, and even negotiated. In a way it is a dialog between the self and others. In response to a request and because the subject keeps coming up,...

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TIFT #71: De-Confusing Memory Reconsolidation tift Feb 28, 2023

Yes, as therapists, we seek to change EMPs (Entrenched Maladaptive Patterns), and Memory Reconsolidation is the final common pathway for essentially all enduring change in psychotherapy. But it turns out that the information needing to be modified comes in four quite different flavors. In...

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TIFT #70: Affect Avoidance–Universal and Central biweekly blog post Feb 14, 2023

 

Avoiding uncomfortable feelings is familiar to all of us. How often do we have trouble engaging in those difficult conversations that are often the most productive? Furthermore, the concept has an important place in a number of therapies. Cognitive-Behavioral Therapy has recognized the...

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TIFT #69: When Progress Leads to Problems biweekly blog post Jan 31, 2023

 

This post is about the ways that therapeutic gains can surprise us and our clients when they lead to painful negative experiences. The bottom line is that being ready to help clients prepare for these events can turn bad experiences into positive ones.

Backlash

That’s the term I...

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TIFT #68 When Boundaries Become Barriers tift Jan 17, 2023

 

“I don’t do that.” Wouldn’t it be nice if setting a boundary were that easy? The client would understand that this is simply part of the method and accept the limitation without complaint with no subsequent fallout. Why not? Adults accept all kinds of arbitrary...

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TIFT #67: Becoming a Better Therapist tift Jan 04, 2023

 

The second day of 2023 seems like a good time to think about becoming an even better therapist. We all have doubts and areas where we can grow. In this post, I’ll share some possible directions for deepening our understanding and practice. 

My training, like that of...

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TIFT #66: Year in Review 2022 tift Dec 20, 2022

 

This year has seen publication of 25 issues of “Tuesday is for Therapists.” With each issue, I, myself, learn and make use of these nuggets in my own practice. I hope they are as useful to my readers. 

I have one wish for my readers. Please share your questions and...

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TIFT #65: Accurate Empathy Clarified tift Dec 07, 2022

 

A reader pointed out that I have been using Carl Rogers’ concept of “accurate empathy” differently from Rogers, himself, and that has caused some confusion. I’m glad for a chance to clarify, but even more important this issue sheds light on the transformative...

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*** Residents and Fellows in Psychiatry Course enrollment ending Sunday***