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 even recognized as...

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, children have a b...

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 decision, some better t...

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 owe ...

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, let’s look dee...

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 practice, ...

“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 rules and only complain mildly when...

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 most of us, was all about app...

This year has seen publication of 25 issues of “Tuesday is for Therapists.” With each issue, I, myself, learn and make use of these nuggets in my own practice. I hope they are as useful to my readers. 

I have one wish for my readers. Please share your questions and clinical conundrums. I am alwa...

A reader pointed out that I have been using Carl Rogers’ concept of “accurate empathy” differently from Rogers, himself, and that has caused some confusion. I’m glad for a chance to clarify, but even more important this issue sheds light on the transformative experience of moving from therapy as ...

We all know that when clients show emotion in their sessions we are on the right track. We also know that purely intellectual interpretation or reframing is not effective. But the pipeline between client and therapist and between consciousness and the limbic system bears a harder look. It is comp...