Anne, in her mid 50s illustrates several common problems and how they can be resolved. She grew up with an alcoholic father who was physically abusive to her mother and hypercritical of his children. Her mother died when she was seven.  She started therapy in her twenties,...

In the early 70s, I was taught mostly to keep my mouth shut when doing psychotherapy. In fact, one residency didn’t select me because they saw (correctly) that staying quiet would be a real challenge. Fortunately I did match with a great residency, Albert Einstein, where my best...

One of the best summer reads in memory was the late Jaak Panksepp’s Archaeology of Mind. This eye-opening description of our mammalian emotional brain is technical, but fresh and different than anything I have come upon before. Dr. Panksepp, who passed away in 2017, makes a...

How do you tell your patients what you aim to do and how it will work? The old-fashioned answer was that it depended on what therapy you were practicing. Times are changing. Today, we are more likely to try to match the therapy to the patient, but that only highlights the confusion in our...

It is not only interesting, but practically helpful for the clinician to have a sense of how the unconscious mind works. Since something like 95% of our thinking goes on there, it must be pretty important. I’m approaching the question from the point of view of biology, that is, the...

Continuing on the theme of how important development is to the clinician, let’s review some developmental issues in adolescence, which can now be considered to go on until around age 25, when, as a parent wryly observed, "parental IQ begins to move back up to normal." First,...

Increasingly, I have been thinking of EMPs, entrenched maladaptive patterns, as having been invented by an “inner child” to solve a critical problem. I have always thought development was important, but experience has taken me further in that direction. At this point,...

A blog reader in her late 30s asked how attachment issues might be related to her recent symptoms of anorexia nervosa. As she has resolved painful memories of sexual trauma she has experienced more distress about relationships. She reports: “I just don’t think I matter...

In TIFT #14, I talked about my personal goal to see the psychotherapy integration movement turn from seemingly endless exploration to seeking consensus. At SEPI's 37th Annual Meeting in June, three of us surprised even ourselves in a Zoom session as we arrived at a core consensus...

This topic is coming into view for a reason. The Pilot group in the Howtherapyworks Training Program has just finished the first trimester on theory and, in our next term, will be working on therapy skills and technique. In this post, I want to use the concepts of Entrenched...

Not everyone of adult chronological age feels or functions like a full adult. This TIFT is about those individuals. I suppose every therapist has a personal list of “syndromes” or patterns they recognize but don’t find in the literature. This is one I have found useful...

Words are amazingly precise

A patient in her 30s was defending her mother as she heavily blamed herself for her ongoing failure to function. She described how her motherwas sometimes very supportive, buthad been critical and harsh when told of the patient’s plan to attend her...