One of the best summer reads in memory was the late Jaak Panksepp’s Archaeology of Mind. This eye-opening description of our mammalian emotional brain is technical, but fresh and different than anything I have come upon before. Dr. Panksepp, who passed away in 2017, makes a scientific argument fo...

How do you tell your patients what you aim to do and how it will work? The old-fashioned answer was that it depended on what therapy you were practicing. Times are changing. Today, we are more likely to try to match the therapy to the patient, but that only highlights the confusion in our field. ...

It is not only interesting, but practically helpful for the clinician to have a sense of how the unconscious mind works. Since something like 95% of our thinking goes on there, it must be pretty important. I’m approaching the question from the point of view of biology, that is, the available hard...

Continuing on the theme of how important development is to the clinician, let’s review some developmental issues in adolescence, which can now be considered to go on until around age 25, when, as a parent wryly observed, "parental IQ begins to move back up to normal." First, let’s go through a cl...

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, for the majority of my thera...

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 on the common in...

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 Maladaptive Patterns ...

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 in many circumstances.

Th...

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 friend’s bacheloret...

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, suggesting t...

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 noticed how di...

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 benefit...