Today's post is to share a recent experience teaching psychotherapy to psychiatry residents from raw beginners to those with some experience. A group of us from the Psychotherapy Caucus, a special interest group of 1500 psychiatrists within the American Psychiatric Association, developed and pres...

Darwin shocked the world into a new level of humility when he showed that humans aren’t the center of the world but derived from apes. Well, the wave of humility hasn’t quite finished its washing up the beach. The last barrier is consciousness-centrism. I, too, have been guilty of seeing the mind...

In this post, I want to suggest some principles that guide my work with couples as well as how I think about them in individual therapy. These are mostly ideas I haven’t seen in the literature, and I hope they will help to simplify as well as inform the work we do.

First, when I see couples in t...

Writing a book is not just putting down what one knows, it’s a journey of discovery. Chapter 2 of the upcoming How Psychotherapy Works: Navigating the Therapeutic Space with Confidence is about coming to appreciate and even love the inner selves we encounter in our work. The clarity I want to sha...

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 creativity, hyperfocus, ...

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 fair a...

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 or not, can ...

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 self-imposed,...

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 growth is about creati...

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 seated personality problem. I’ll c...

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 other serious s...

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 followed the path of the Five Key ...