Therapy Today

There are patients who no matter how much the therapist asks and invites: “Do you notice, do you notice… would it not be nice…. would you like to….” etc., etc. it will not gain traction. No amount of inviting or trying to...

It’s wonderful when treatments lead to major success and character change, but I will go out on a limb and assume that no one always succeeds and that no one never makes mistakes. I want to contribute to a culture where those...

I have been reflecting on what constitutes the fingerprint of ISTDP and on explanations for the variability in the application of the model. I will opine, blogpost format, on both of these issues, starting with the latter.  For starters, I assume that all...

What do we do when defenses and resistances crop up early on in a session before a conscious therapeutic alliance and an agreement has been established about the therapeutic task? Tactical defenses are particularly common — gaze avoidance, vague and imprecise speech,...

— Transference behaviors here meaning both ‘resistance’ in the narrow sense  as well as distorted perceptions and unconscious attempts by the patient to pull us into enactments Stepping out of the shoes and the universal wound  Nothing really therapeutic and healing happens when we are in...

Here are a few brief and far from exhaustive reflections for ISTDP-informed therapists interested in the technique of portraiting the impulse component of emotions and feeling-states, such as rage, longing, and tenderness.  When portraiting, we want to first and foremost be clear about our aim....

— a Skorman/Kieding amalgamation perspective In couples therapy, you are initially dealing with needing to establish two separate conscious therapeutic alliances that have enough overlap so that there is a shared vision for what changes they each aspire towards. This shared vision, if...

Consider the idea of pseudo-contact: the patient who is using the relationship with the therapist as a defense. The patient uses the supportive relationship with the therapist as a defense, allowing them to keep others at a distance because they are getting some pseudo-contact with...

Observations from thousands of hours of both individual and couples therapy sessions: The patient that monologues, gives speeches, and answers their own questions (and/or dictates to the therapist how they want the therapist to do her job): Th: Do you notice how you are...

We are always filtering the data out patients share with us through the lens of our training and previous experiences. We would not be very functional if we didn’t.  I have noticed a pattern in trainees where perceptual flexibility is sometimes lacking and they too...