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,...

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...

The pathway starts by narrowing our view to precisely what psychotherapy aims to treat. As discussed in TIFT #11, this leads to identifying Entrenched Maladaptive Patterns (EMPs), as the basic units of pathology treatable in psychotherapy. From there,we bring in evolutionary biology,...

Here’s the secret:

Treating inappropriate shame is one of the hardest jobs in psychotherapy. Knowing this and understanding why will help you know what to do and how to manage expectations. The surprising thing is that, as far as I can tell (and I’d love to know otherwise) no one has...

A consumer wrote this. I’ll call her Joan:

"How can adults who have never had safe secure attachment, meet these needs and become healthy well adjusted adults? If we are not able to see a good therapist because of being too debilitated by complex trauma to be able to work and therefore have...

The Problem

For the past 11 years I have been blogging about serious psychotherapy, especially about “attachment to your therapist.” Far too often I have been saddened to hear about patients abandoned by their therapists or harshly discharged by clinic administrators when they dared...

You probably haven’t heard the term antidote used in this context, but I’m proposing it because it is really helpful in bringing together elements from many therapies. It describes one of just three core elements that need to be present for psychotherapeutic change,...

This is the first of a series of Tuesday emails offering useful tidbits for clinical psychotherapy. Normally this will be on Tuesday, but this is the first time. Oh well...

This post is about making sense of some very difficult problems in psychotherapy through a developmental point of...