Tuesday is for Therapists: Biweekly Essays

TIFT #81: Applying the Affect Avoidance Framework tift Jul 18, 2023

 

This is a continuation of TIFT #80, Confronting Therapist Anxiety. Here I share my own experience combining clinical knowledge with modern neuroscience to activate old patterns and deliver disconfirming information such that it reaches the limbic neurons where information needs to be rewritten.

...
Continue Reading...
TIFT #80: Confronting Therapist Anxiety tift Jul 04, 2023

 

The Dunning-Kruger Effect describes the fact that people of low competence tend to think they are highly skilled. At the same time, social researchers, Dunning and Kruger (1999), in a classic article, note that:

“Top-scoring individuals know that they are better than the average, but they are no...

Continue Reading...
TIFT #79: Scientific Psychotherapy: The Dark Horse Surges Jun 20, 2023

 

Western medicine has made relentless progress in the use of scientific understanding of disease to develop more effective treatments. In mental health, Psychiatry has ardently desired to follow the same trajectory, but has not made the same kind of progress. In its all out attempt to do so, it ha...

Continue Reading...
TIFT #77: Helping the Stuck Adolescent tift May 24, 2023

 

This is a follow-up to the previous post on how treating symptoms and diagnoses is so often unsuccessful because the real source of trouble is underlying immaturity, a very real problem that, unfortunately, has no diagnosis code. In that post, I described the problem. In this one, I discuss some ...

Continue Reading...
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 even recognized as...

Continue Reading...
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, children have a b...

Continue Reading...
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 decision, some better t...

Continue Reading...
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 owe ...

Continue Reading...
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, let’s look dee...

Continue Reading...
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 practice, ...

Continue Reading...
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 phenomenon...

Continue Reading...
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 use when client...

Continue Reading...
1 2 3 4 5 6 7 8 9 10 11

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