According to Wikipedia, "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 abo...

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 ins...

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, ...

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...

“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,...

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 hea...

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 trea...

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 p...

One of my best summer reads was Amir Levine and Rachel Heller’s 2010 classic, Attached. Maybe I should be embarrassed for coming to the party late and even more from learning about it via my patient’s dating coach, but this book, aimed at a popular audience, goes beyond Bowlby’s basic concepts in...

How a Lack for Primal Love can Heal

A reader writes: “I feel like I’m done with therapy but not done with my therapist. The only reason I’m still going after many years is that I am so deeply attached to him and can’t imagine life without him in it. I’ve worked through many of my issues and we t...

The idea of primal love comes from working with clients who have been deprived in early life. Many of the people who responded to posts (on the howtherapyworks.com blog) about attachment to your therapist have found themselves looking for something their therapist could not give them. A key quest...

For the therapy consultant there is usually one easy answer. When therapy is stuck it’s a transference problem. Yes, there are exceptions. Enabling, whether from family or the an institution, can guarantee that no change will happen. I’m sure there are others, but in the vast majority of cases, t...