This post is built on what I often say to adult clients with ADHD. 

ADHD has advantages as well as challenges

We start by countering the negatives about ADHD. This form of neurodiversity comes with definite advantages along with the challenges. The main positives are...

For many, knowledge of what is fair is taken for granted and not even thought about, but in therapy it can be a source of real questions. Clients wonder what life owes them and what they should give back. With dysfunctional families and trauma, children grow up with skewed ideas of what is...

In earlier posts, I haven’t made much of the distinction between guilt and shame, but guilt has unique features that have recently come into sharper relief. I see how often adult clients still feel guilty for things that happened when they were children and how old guilt, appropriate...

This post is about intense emotions around our natural abhorrence of constraint. We have all seen how far down the chain of evolution the desire for freedom is manifested. Animals, even insects, almost universally struggle to remain free when constrained. Constraint can be forced or...

I’ve been writing a lot about memory reconsolidation, but perhaps half of the work in my practice is helping people restart psychological development where it was left off. Development doesn’t necessarily involve my favorite change mechanism, memory reconsolidation, because...

Recently I have been involved in situations where someone who could clearly be called “borderline,” was rather suddenly “cured.” In both cases, I had been working with parents and felt the problem was better understood as a developmental issue rather than a deep...

Returning from vacation I’m finding young people and parents rightly concerned about intense and frightening symptoms connected with the demands and stresses of returning to school.They are understandably distressed about severe anxiety, suicidal thoughts, intense compulsions, and...

Linda revealed that the source of her shame was “Penelope,” the name she gave to an inner critic who cut her to shreds for any attempt to live a brighter, more interesting life. In this post, I’ll show how our quest to deepen our understanding and support change...

Most of us light up when we see a small child. That’s how we want to respond to the our own and our clients’ inner selves. I’m afraid I haven’t made that as clear as I would want, especially because that inner child is so often the main character in the drama of...

Seeking accurate empathy is a good way to create the conditions for change. That is the theme of the Five Key Questions approach to teaching core psychotherapy skills. What it means in practice is putting oneself (and the client’s observing self) in the shoes of the limbic problem...

Unconscious emotion is of central importance for us. It stands at an epicenter between the mind’s appraisal of circumstances and the responses we want to help our clients change. Not only is unconscious emotion a necessary trigger for action, but it embodies...

“Where are we and what to do next?” These questions come frequently as we practice psychotherapy, sometimes in the background, but just as often arising as conscious questions. This post is about three very different situations and how each has a different tempo...