Tuesday is for Therapists: Biweekly Essays

TIFT #82: "Dare to Share"–When Adolescents Blame Parents tift Aug 04, 2023

 

Internalizers Welcome: Share your difficult problems! Winning subscribers will receive free coaching via TIFT. All you have to do is Dare to Share (see below).

 

We all have difficult cases and doubts. As internalizers we think first of critiquing...

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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...

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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...

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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...

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