Quotes on Therapy

[David Baxter PhD]

https://kungfupsychiatry.com/articles/supportive-psychotherapy-treatment-as-usual

In my community, I can find 10 therapists who primarily provide supportive psychotherapy for every 1 therapist trained in and willing to provide CBT. Most community therapists, even if they are excellent at delivering CBT, Interpersonal Therapy (IPT) or Acceptance and Commitment Therapy (ACT), drift away from rigidly adhering to those models and end up performing a blended therapy. Some of these blended therapies would best be described as supportive psychotherapy, especially if no homework is given to the patient between sessions.

To be fair, some clients are resistant to certain therapies and some are simply resistant to doing homework of any kind between sessions. The therapist has to know not only what works but what will work for a specific client, and that is often the primary reason for moving to blended or modified therapies.

 

[Daniel E.]

Or, as they do here, just bring in the horses which would be quite grounding if I didn't already have so many animals.

I was surprised to learn my insurance could pay for a reiki provider who also provides horse therapy. At least trying to not get kicked by the horse could be exposure therapy

 

[Daniel E.]

"The job of the autonomic nervous system is to ensure we survive in moments of danger and thrive in times of safety. Survival requires threat detection and the activation of a survival response. Thriving demands the opposite-the inhibition of a survival response so that social engagement can happen. Without the capacity for activation, inhibition, and flexibility of response, we suffer."

― Deb Dana, The Polyvagal Theory in Therapy: Engaging the Rhythm of Regulation

"The Polyvagal Theory provided us with a more sophisticated understanding of the biology of safety and danger, one based on the subtle interplay between the visceral experiences of our own bodies and the voices and faces of the people around us. It explains why a kind face or a soothing tone of voice can dramatically alter the way we feel. It clarifies why knowing that we are seen and heard by the important people in our lives can make us feel calm and safe, and why being ignored or dismissed can precipitate rage reactions or mental collapse. It helped us understand why attuning with another person can shift us out of disorganized and fearful states. In short, Porges's theory makes us look beyond the effects of fight or flight and put social relationships front and centre in our understanding of trauma. It also suggested new approaches to healing that focus on strengthening the body's system for regulating arousal."

~ Bessel van der Kolk

 

[Daniel E.]

Trauma in the family is always in the rear-view mirror, transformed and resolved only when it is finally acknowledged and addressed.

~ Freeing Ourselves from the Ghosts of Our Past

 

[Daniel E.]

"Psychotherapists have a role to play not just in the area of mental health, but in social justice as well. There’s a richer journey there and I think a lot of therapists are frustrated just dealing one person at a time at a time with the results of a society that just doesn’t know how to support people in being more fully human. You can be in your therapist role but also be part of a social change effort that is linked directly to the clinical work that you’re doing."

~ Steven Hayes

 

[Daniel E.]

Tell clients in their first session that you value feedback. Encourage them to reach out to you with any difficulties or disappointments that come up during the therapy process. Letting them know you will listen to what they have to say can help foster a strong therapeutic relationship. Being open about disagreements can help prevent resentment from interfering with treatment.

~ GoodTherapy

 

[Daniel E.]

"Can it be that we are training a cadre of professionals who are especially adept at curing fears of snakes and spiders and peculiarly inept at treating conditions of demoralization after they have been carelessly diagnosed as affective disorders?"

~ William Schofield

 

[Daniel E.]

Pretty much all of my ideas get shot down by the patient, until he or she finally stumbles across the feeling or problem that is being repressed or avoided. I put out hypotheses, “could it be this” or “could it be that,” and the patient says, “no, that doesn’t resonate.” Then, after a few misses, and a few sessions later, the patient will often say, “Oh, there is this thing I forgot to tell you about.” And then, Bingo, yo’ve suddenly got it!

~ David Burns, MD

 

[Daniel E.]

I'm Working On It in Therapy: How to Get the Most Out of Psychotherapy




Regarding the first point about masks:

 

[Daniel E.]

"Going to therapy is one of the bravest, smartest, strongest actions you can take."

~ Margarita Tartakovsky, Think Going to Therapy Makes You Weak or Weird or Wrong?

 

[Daniel E.]

When Your Good Therapist Turns "Bad" - Psyched in San Francisco

Just like people in “real life,” your therapist is occasionally going to let you down.

www.psychedinsanfrancisco.com

“We desperately want to feel understood and cared for, but the people in our lives don’t always “get” what we’re trying to communicate….These “empathic failures” are actually a great opportunity to heal your childhood wounds by talking about them, rather than withdrawing.” – Carol Gould

 

[Daniel E.]

"The first therapist you can get an appointment with is not always the one who’s right for you. I think it’s important to talk to a few people and see who you like rather than what’s convenient."

~ Jessica Treat, MFT

 

[Daniel E.]

"All of our problems are human problems that reflect our human story."

~ Robert Berezin, M.D.

 

[Daniel E.]

"Therapists spend a lot of time and energy arguing among themselves about the theories and techniques we use to help people, and much of that is lost on the clients who seek our help. Most clients...just want to know if their therapist cares and can help them."

~ Ryan Howes, PhD, ABPP

 

[Daniel E.]

15 Signs You Should Fire Your Therapist

Before you pay for another lackluster therapy session, make sure you know these surefire signs you're working with a bad therapist.

bestlifeonline.com

Your therapist is a professional, but they're not omniscient. Much like any other clinician, therapists can make mistakes in their diagnoses. That said, if you've raised an objection to your therapist's diagnosis and you feel like you're not being heard, it's time to move on.

 

[Daniel E.]

Does “difficult patient” status contribute to functional demedicalization? The case of borderline personality disorder

A diagnosis of Borderline Personality Disorder (BPD) often signals the quintessential “difficult patient” status to clinicians, with at least one scholar arguing the condition itself was created to name and group difficult patients. While ...

www.ncbi.nlm.nih.gov

“Patients who were diagnosed as having borderline personality disorder were judged more negatively than were patients with other diagnoses—schizophrenia for example—although their difficult behaviors, such as expressing emotional pain or not complying with ward routine, were equal.”

“There’s an effective treatment. And most individuals with BPD really, they’re not affecting people’s lives negatively because they want to, or because they’re trying to be manipulative, they just want the pain to go away.”

Carefully controlled trials show that patients with BPD are just as treatable as patients with Major Depressive Disorder, the most common diagnosis in the United States.

 

[Daniel E.]

Borderline Personality Disorder

Clinical Update on Borderline Personality Disorder, offered by Zur Institute for Psychologists, MFTs, SWs and Counselors

www.zurinstitute.com

Many treatment failures with BPD clients may be due more to therapists’ hesitations and defenses than to the “intractability” of BPD.

 

[Daniel E.]

"When you say ‘self-care,’ lots of people think about pedicures and bathtubs. But self-care for me is about a decision point: How do I create a context for myself, and for my family, that’s good for us?”

~ Rheeda Walker, PhD, author of The Unapologetic Guide to Black Mental Health

 

[Daniel E.]

Is Routine Outcome Feedback Informing Your Practice? (Part 2 of 2) - OQ Measures

Is Routine Outcome Feedback Informing Your Practice? (Part 2 of 2) Last week we learned about Dr. Tony Rousmaniere’s heartbreaking experience with Grace – a client that unexpectedly died of a drug overdose, prompting a career crisis for Tony, which drove him to find routine outcome monitoring...

www.oqmeasures.com

Like the widespread adoption of the thermometer to the medical field back in the 19th century – 250 years AFTER its invention – use of psychotherapy metrics and feedback systems has been slow.

 

[Daniel E.]

Do You Have Trouble Dealing with Ambivalent Feelings?

Tolerating ambivalence is essential for maintaining a long-term relationship.

www.psychologytoday.com

Part of the experience of psychoanalysis is learning that we have many complicated and contradictory feelings about people. We cannot get rid of them; but we do not have to act on them. Rather, we must accept that we have conflicting feelings but weigh them before we act on them. Tolerating ambivalence is essential for maintaining a long-term relationship.