Announcement: In 2022, I’m planning to reduce the frequency of TIFT to every other week. The next one will be on January 18, 2022. With this post, I’m proposing practical guidance to make psychotherapy more effective. The idea is simple. Giving ourselves and our clients the task of discovering what it is they most dread will turn out to be surprisingly helpful. Here’s why. Essentially all of the EMPs (Entrenched Maladaptive Patterns) that our clients want to change represent the mind’s ways of avoiding what they most dread. By daring to explore the nature of that dread, we do far more than sat ..read more

Thanks so much to the readers who commented on “It’s the Love,” Post #36. How often does a therapist get to participate in a genuine dialog with clients outside of a therapeutic relationship? I hope many therapists are taking the time to read the 25 comments on that post. They are incredibly valuable and instructive for all of us. In October, 2019, I tried to write the definitive post about resolving the intense attachments and underlying pain that survivors of trauma and neglect most dread. I got right it that grieving the shortfall was not the answer, but a commenter on the recent post said ..read more

According to Wickipedia, “Overchoice… is a cognitive impairment in which people have a difficult time making a decision when faced with many options.” As long as therapists have an infinite choice of things they might do next, the result is bound to be distressing and confusing. This post is about how to make better choices more easily. One common answer to the problem of overchoice is to follow a method or protocol. That does reduce therapist anxiety, but is limiting and rarely just right for the specifics of client and situation. In the 21st Century, we can do better. With today’s understand ..read more

We’ve almost given up on theory and it matters Joseph Priestly, a British clergyman and scientist was a believer in the then-current theory of phlogiston, which explained why putting a jar over a burning candle put out the flame. The flame was believed to produce phlogiston, and when the air inside the jar became saturated with the substance, the fire would go out.  In 1774, two years before the Declaration of Independence, he told the famous chemist, Lavoisier, about an experiment in which he produced a substance that did the opposite. His new,”dephlogisticated air” actually promoted bur ..read more

This is a post for holiday time, when heightened needs and expectations so often lead to family conflict. In an update to a post published in 2006, I’m looking at it a bit more from a therapist’s point of view. Kelly wrote, “In the past few years, having moved back in the vicinity of my family, I find it extremely hard to tolerate them. After years (lifelong) of discounting, minimizing, and scapegoating by them, it seems I’ve become so healthy I can barely be in their presence because they are such wounded, fearful, unloving people. I used to respond to this with compassion and deep down I th ..read more

To direct or not to direct change? Should therapists be invested in a particular target change? Psychodynamic as well as Rogerian Client Centered Therapy have a tradition of holding back opinions and not telling clients what to do. I’m going to argue that our actions should be guided by the same principle as parents. When our clients don’t have a reasonable chance of making a wise choice, then we do them a disfavor by standing by as they flounder. When they are capable, then doing for them what they can do for themselves is infantilizing, sending a message that we don’t respect their abilities ..read more

“It’s the love,” that is what a good friend and experienced therapist dared to say some years ago. Let me take a break from the series of posts about therapist objectives to discuss recent comments about healing an intense attachment to one’s therapist. A reader wrote: I guess my hope is that, as someone who teaches therapists, you will nuance your claims about how childhood needs can’t be fulfilled. I think therapists often use this reasoning against clients in ways that are really damaging. And, perhaps more importantly, this reasoning causes people like me to settle for of continued pain ..read more

This post covers two more of ten therapeutic objectives: supporting change in thoughts and change in behavior. Let’s turn the discussion on its head. Most accounts start with why one should change. Instead, let’s ask why not? Change is hard, for a reason. The aim of this TIFT is to get to the heart of the matter by looking at what prevents positive changes from happening. Reptilian reasons not to change Among the hardest are the behaviors that support physical survival. Giant Businesses base their success on promising satisfaction of human instincts for eating high calorie food, avoiding pain ..read more

In the last post, the subject was how to awaken emotions. In this one, we discuss what to do when emotions are already active and causing distress. Working with painful, uncomfortable, and overwhelming emotions is a large part of what we do. Sometimes strong emotions are what bring people to treatment. At other times feelings arise in the course of doing the work. Either way, when difficult emotions are activated we want to do something to help. What we focus on doing divides into two tasks. First, when emotions are dysregulated and the person is in survival mode, we need to bring d ..read more

An interesting way to focus on the processes of psychotherapy is to ask what immediate objective we are pursuing at a given moment. As we work, we are generally aware of trying to accomplish something specific. By naming our objective, we can focus more clearly on the processes that might be in play. This post started out as a review of my own cases, where the list of objectives kept growing to the current number, ten. Today’s TIFT is about the first two objectives and the processes they support. 1. Learning all about the problem Right from the beginning we want to have enough of a picture of ..read more