By Arthur Becker-Weidman, Ph.D., Dyadic Developmental Psychotherapy Topic Expert Contributor

Click here to contact Arthur and/or see his GoodTherapy.org Profile

Dyadic Developmental Psychotherapy, which is an evidence-based, effective, and empirically validated treatment is composed of a variety of elements and based on a number of principles that have strong empirical support. Dyadic Developmental Psychotherapy is, in some respects, an amalgam of effective principles of treatment. This article will describe the elements of Dyadic Developmental Psychotherapy and a few of its underlying principles.

It is helpful to remember that everything begins with building an alliance. “Without an alliance there can be no secure base. Without a secure base there can be no exploration. Without exploration there can be no integration. Without integration there can be no healing.” Read the rest of this entry

By William “Sandy” Pryor, MA, LPC, MT-BC, Gestalt Therapy Topic Expert Contributor

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When I tell colleagues that I am a Gestalt therapist, I generally hear “so you hit pillows” or “so you just talk to an empty chair.” The general lack of understanding of basic underlying theory and guiding philosophy is surprising given the approach’s popularity and influence over that last 60 years. In this article I would like to describe and discuss a concept that is at the heart of Gestalt therapy. This concept is the Gestalt “cycle of experience.”

In Gestalt Therapy, the self is not seen as a static thing but rather as a continually evolving process that is defined and illuminated by how the organism (client/person) makes contact with his or her environment. This process, when completed in a healthy and unimpeded way, generally follows a process called the “cycle of experience.” This cycle is a basic map for how a person becomes aware of a need, mobilizes to meet that need, and achieves satisfaction. The key phases of the process are sensation, awareness, mobilization, action, contact, satisfaction, and withdrawal/rest. Read the rest of this entry

By Jaffy Phillips, MA, Hakomi Topic Expert Contributor

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Hi, my name is Jaffy Phillips. I am a certified Hakomi therapist, and I have studied a number of other body-centered approaches to therapy as well. I volunteered to be the topic expert for Hakomi therapy here at Goodtherapy.org because I feel that Hakomi makes such an important contribution to the larger field of psychotherapy, and because it is really the foundation of my own practice.

There are so many wonderful things about Hakomi that it is impossible to address them all in one short article. Instead, what I would like to do here is to speak a bit about what makes it so special to me, and to briefly introduce some of the topics I will be covering in upcoming articles (monthly). Read the rest of this entry

By Roni Weisberg-Ross, L.M.F.T., Abuse Topic Expert Contributor

When we think of children who have been sexually abused, we think of fear, anger and violence. Most sexual abuse survivors talk of the terror and disassociation surrounding the abuse. Many still feel that way as adults and don’t enjoy sex now, even in a loving relationship. But there are those who have a more complicated story to tell. These survivors may have hated their abusers but experience an unspeakable shame over the fact that their bodies responded sexually to the abuse. They cannot live with the knowledge that they were sexually stimulated even as they were being raped. Now they are not only healing from the abuse but from the additional belief that they were partially responsible for the abuse - and that they may even have deserved it.

While adult survivors can intellectually understand that as children they were victims of their abuse, they don’t always feel that way. And they certainly can’t accept that fact if they responded sexually. Many of them can’t imagine how a child could respond sexually. So they believe that not only are they dirty, but that they are freaks as well. Yet children do have sexual feelings. Toddlers can sexually arouse themselves. And as they get older, many of them experiment and discover that their bodies respond. The myth that hormonal changes occurring at adolescence are the beginning of sexual feelings is just that, a myth. Read the rest of this entry

By Rachel Fleischmann, LCSW, Dance / Movement Therapy Topic Expert Contributor

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“We’re all bozos on the bus,
So we might as well sit back
And enjoy the ride”
~Wavy Gravy

As psychotherapists, we wear many hats; that of thinker, change agent, magician (if only….), loving detective, spiritual guru, compassionate witness, and more. We do everything we can to be consistent, kind and well put-together for our clients. This of course, is in their best interest; they need and deserve a sacred and safe container. We, essentially, are the constant object. We are also human, and prone to error. We need reminders that our human-ness is okay. I am offering some of my favorites. Read the rest of this entry

By Peggy Gold, MS, NCC, LMHC, Narrative Therapy Topic Expert Contributor

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In my private practice, my clients are often struck by the way I react to their experience and reports of intense emotional pain. Examples of such pain include their expressions of anger, sadness, rage, sorrow, frustration, shame, guilt, or devastation. I see these expressions as entry points for the development of a new, more preferred storyline. A storyline that can be explored with my client and rooted in their own responses to pain, this type of therapeutic inquiry is known in Narrative Therapy terms as “Absent but Implicit.” What is not being said, but is being implied by what is said? Thinking within this framework, I am able to ask questions that help people access what is important to them, what they hold precious, and help them claim their own personal agency.

To explain this concept, I will draw on the analogy of the experience of physical pain. Read the rest of this entry

By Beth S. Patterson, MA, Grief & Loss Topic Expert Contributor

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Grief theorists, in keeping with Western culture’s emphasis on autonomy and individuation as signposts of psychological health, have long held that disengaging from the deceased is necessary for the successful resolution of grief (Marwit & Klass, 1995). For example, according to the psychoanalytic view of Freud (1917), grief work entails decathecting, or detaching libidinal energy from the deceased. Furthermore, the attachment theory of Bowlby (1969) posits that the bereaved individual attempts to maintain a bond to the deceased until he or she realizes the impossibility of doing so, and eventually “lets go” of his or her relationship to the deceased. Read the rest of this entry

By Kalila Borghini, LCSW and Ordained Yoruba Priest, Spirituality Topic Expert Contributor

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What better place to begin my tenure as a Topic Expert on Spirituality than with the Ancestors. By “ancestors” I mean those in our bloodline who have passed on. And so I open this article with the Yoruba saying “maferefun egun” which means “I give praise to the Ancestors.” Indeed, none of us would be here without them. And whether we know much about them or even liked most of those that we did know is less important than our acknowledgement of their role in our lives. Read the rest of this entry

By Pamela Lipe, MS, LP, Relationships & Marriage Topic Expert Contributor

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Jonathan and Michelle came to my consulting office looking for someone to help them make a decision about the upcoming holidays—especially Thanksgiving with parents. Jonathan said Thanksgiving was his mother’s favorite holiday. After dinner, she would drive the men out of “her” kitchen. They would watch the game and she would clean up. When Jonathan and Michelle were married two years ago, Michelle was brought into the family fold and treated by his parents as one of the children. Michelle loved Jonathan’s parents but was taken aback when his mother expected her to participate in the preparation and clean up while “the boys” watched football. Michelle wanted to relax and watch the game too. Michelle decided to go along with Jonathan’s family tradition in the first two years but began to feel resentful towards Jonathan and his family. Read the rest of this entry

By Ce Eshelman, LMFT, Attachment Topic Expert Contributor

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Attachment is the foundation upon which all human relationships are built, and touted by many as the most powerful predictor of all life successes. It is a wonder that something this integral to human existence is also so often overlooked and misunderstood by therapists who are considered relationship experts. When examining social work and counseling graduate degree programs, I am not surprised to find the typical program to have one obligatory course entitled “Development throughout the Life Span” and in atypical graduate schools there might be one additional course entitled “Child Development.” Unless the school is known for its focus on attachment theory, very little is taught to potential therapists across the country about attachment processes, attachment issues, attachment interventions, attachment treatment, or attachment healing. Unfortunately, we relationship experts often turn out to be humble students of the myriad of people in our offices struggling to heal the slings and arrows of attachment wounding. Being “as a student” can be a sensitive and wise way to approach another’s life lessons. However, in issues of attachment there is wisdom in becoming a scholar and knowledgeable practitioner in the theory and science of love. Read the rest of this entry

By Arthur Becker-Weidman, Ph.D., Dyadic Developmental Psychotherapy Topic Expert Contributor

Click here to contact Arthur and/or see his GoodTherapy.org Profile

In this first article here I will describe what Dyadic Developmental Psychotherapy is. Dyadic Developmental Psychotherapy began as a family-therapy approach, grounded in attachment theory, for the treatment of children with disorders of attachment. It has developed over the past decade into a broader approach for treatment and has been found to be an evidence-based, effective, and empirically validated treatment.

Dyadic Developmental Psychotherapy has as its central therapeutic mechanism the maintenance of a contingent, collaborative, sensitive, reflective and affectively attuned relationship between therapist and child, between caregiver and child, and between therapist and caregiver. Dyadic Developmental Psychotherapy focuses on and relies upon the intersubjective sharing and joint development and organization of emotional experience. Intersubjectivity refers to shared emotion (also called attunement), shared attention, and shared intention. Read the rest of this entry

By Michael Etts, LMSW, NBCCH

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“Man’s task is to become conscious of the contents that press upward from the unconscious.” — Carl Gustav Jung

“If she walked into my life again” came onto the radio. He raised his hand as if in a silent request, then closed his eyes and dropped his head slightly to the right. His previously opaque face had become flush with emotion and I almost didn’t recognize him. It was clear that he had left his 82 year old body behind and was returning to a memory whose raw power was palpable. Everyone knew it was time to be quiet.

In my silence, I began to wonder about his life choices and his regrets. And more generally, what causes people to make regrettable choices and what makes good choices possible? And all I could think was how it all leads back to the unconscious. Although I feel in control when I have my hands are on the steering wheel, I believe that it is my unconscious which actually makes the turns. The task then, of a fully conscious person, is to uncover those unconscious motivations so that fully informed choices are possible. Read the rest of this entry

By Anne Ihnen, MA LMHC

Sitting in meditation means sitting with what is. The challenge, of course, is that a lot of what is doesn’t feel very good: we experience fear, restlessness, grief, anxiety, shame. For many of us, these experiences are enough to send us fleeing from the cushion, convinced that meditation isn’t for us or that we’re doing it wrong. Others convince themselves they’re meditating when they’re actually engaging in spiritual bypassing, a term coined by John Welwood¹ that refers to the use of spiritual practices to avoid facing pain. When these things happen, a therapist can help us return to the present moment and stay present with what we find there.

When I sit with a client, I pay attention as closely as I can to what I receive through the six sense doors. I consider all of this material relevant, even my own thoughts and emotions. Therapists in my orientation talk about “the field”, which is the space between two people, the place where we throw our unwanted, unacknowledged feelings and experiences. My job is to notice these things, setting aside material that’s clearly about my own personal life, and paying attention to all that remains. In this way, I am focusing on the present moment and trying to stand in the midst of it all, even if it’s painful, frightening, or confusing.

When it seems helpful or relevant, or when what I’m noticing is persistent and strong, I reflect the experience back to the client. This is done as an offering, a pointing to what’s happening now; it’s an invitation to the client to check his/her own experience to see if it matches what I’m noticing. In this way, I invite the client into the present moment. This doesn’t mean that events outside the therapy room or experiences from the past are never discussed. On the contrary—these topics are the heart of therapy. But as they’re explored, the invitation is offered to step back into the present to see how it feels to be talking about these things now. And as we do this, we face the pain that’s there in the present moment together, seeing that it is possible to stand in the middle of it all, even if it’s just for a moment or two.

As we engage in this work of coming back to what is, the client begins to recognize the pain as his/her own cast-off experience. And with this recognition, compassion arises and healing begins. In this way, the relationship between a therapist and client mirrors the relationship we have with ourselves when we meditate. For those of us who struggle to face what is, working with a therapist can help us find our way back.

¹Toward a Psychology of Awakening: Buddhism, Psychotherapy, and the Path of Personal and Spiritual Transformation, by John Welwood (2000)

©Copyright 2009 by Anne Ihnen, MA LMHC. All Rights Reserved. Permission to publish granted to GoodTherapy.org. The following article was solely written and edited by the author named above. The views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the following article can be directed to the author or posted as a comment to this blog entry. Click here to contact Anne and/or see her GoodTherapy.org Profile

A GoodTherapy.org News Headline

Ireland has experienced considerable difficulty in addressing the perceived problems in its mental health programs, but recent measures to increase funding and the availability of services have helped spark hope for its citizens. However, some important issues still prevail, such as a growing tendency to admit children to adult psychiatric hospitals and other facilities, a practice some officials decry as being abusive. As mental health professionals at adult facilities rarely have necessary training in youth psychology and development, treatment is likely to be substandard and ultimately less effective than specialized care. The country and its mental health advocates hope to increase resources for youth to help mitigate the problem.

© Copyright 2009 by http://www.GoodTherapy.org Therapist Colorado Springs Bureau - All Rights Reserved.

A GoodTherapy.org News Summary

Kenya may not be the first place that comes to mind when considering the psychology hot spots of the world. But a growing community of mental health care professionals in the country is beginning to reap the rewards of concentrated efforts and inspiring diligence as a greater number of the nation’s inhabitants seek therapy and other forms of treatment. Holding its first meeting in what is to become an annual event, the Kenya Psychiatrists Association will meet this week in Mombasa to explore professional connections and networking opportunities while working towards the development of strategies for both greater awareness of mental health services and the amplification of their availability to the public. Though the association is still relatively young, the national interest in mental health care is hoped to help boost attendance.

Having played host to several traumatic episodes during colonization and the struggles for independence and stability, Kenya is home to a population that, while ever-focused on working towards bright goals on the horizon, is also often challenged by painful memories and experiences. The prevalence of mental health concerns among ex-prisoner populations, for instance, is substantial, yet modern services are largely inaccessible to some groups of people who may need treatment most. Read the rest of this entry

© Copyright 2009 by http://www.GoodTherapy.org Therapist Sacramento Bureau - All Rights Reserved.

A GoodTherapy.org News Headline

Taking a leisurely stroll at sunset or starting off the day with a brisk walk has often been hailed as a healthy and invigorating way to incorporate exercise into a healthy lifestyle. Increasingly, the benefits of walking and other forms of exercise are being recognized as useful components of the healing process in clients with feelings of depression. Suggesting that the adoption of an exercise regimen –even if it simply consist of enjoying some therapy sessions while taking a quick jaunt out of doors- can have a significant impact on recovery, especially in clients experiencing emotionally-related lethargy and other undesirable symptoms. The growing acknowledgment of these benefits may lead more mental health professionals to take their work on an amble.

© Copyright 2009 by http://www.GoodTherapy.org Therapist Carlsbad Bureau - All Rights Reserved.

By Daniel Winger, Ph.D.

It’s a familiar scenario for therapy clients the world over: after a particularly intense session in which it seems that a lot of positive work has been done, it emerges that some lie has been told (or that an important piece of information has been withheld), and the course of treatment, as a result, is less effective. In general therapists and other mental health professionals are aware that complete and total honesty, while certainly ideal, is not really the norm, nor can it be reasonably demanded from each and every client. In the past couple of years, the buzz about lying in therapy has been picking up, with publications from major journals and reviews to individual blogs and other online mediums sounding off about the phenomenon. The verdict? It’s best to encourage an honest exchange, accept any moments of coming clean with grace, and to ask adequate questions to ensure treatment is as personalized as possible. Read the rest of this entry

A GoodTherapy.org News Update

The idea of putting the pieces of our lives together only to have them suddenly halted in an accident in the prime of our years is, for most of us, well, paralyzing. Yet that’s exactly what happened in the tale of Daniel Gottlieb, a New Jersey psychologist and family therapist whose journey through the mental health profession was remarkably turbulent. Through a series of trials which may have claimed the professional aspirations of many, this Daniel rediscovered his love for helping people reach their full potential and conquer their concerns.

After establishing a therapy practice and settling down with his wife, Daniel’s progress toward achieving the dream he’d visualized seemed to be putting him within close reach of his own concept of success. But at the age of 33, the budding counselor was involved in a serious car accident which left him paralyzed from the neck down. While coping with the ensuing trauma and adjusting to the new constraints and demands of day to day life, the therapist experienced another round of difficult times; his wife divorced him and several members of his immediate family passed away, all within the scope of a few years. Daniel recounts an especially dark night spent in the intensive care unit of a hospital, feeling oppressed by his life and the events that had recently occurred and established themselves as the core of his reality. That night, a distraught nurse approached him asking for advice or assistance in coping with the death of a loved one, and as Daniel helped guide her through her grief, he realized a profound well of compassion and love of life within himself. Read the rest of this entry

© Copyright 2009 by http://www.GoodTherapy.org Therapist Longmont Bureau - All Rights Reserved.

By Gary Seeman, Ph.D.

Click here to contact Gary and/or see his GoodTherapy.org Profile

Awareness is Ever-Present

To be aware is to witness. And our witnessing selves are always there when we dream, [1] in daily activities, when feeling emotions, and in states of excitement or distress. We are constantly aware, though our focus may be clear or muddled. Without awareness, there is no consciousness. But awareness is hard to see. It is ever-present, like the air we breathe.

Although always present, awareness may not be remembered. For example, we may walk around a table while moving from one room to another. But we let our perception of the table recede from consciousness without storing memories that are easily retrieved. The encoding of memory depends in part on the intensity of experience, whether this intensity is influenced by the strength of a sensory perception or an emotional response.

We are self-aware when we attend to representations of experience - whether drawn from memory or visualizing a possible scenario. In psychotherapy, we train awareness on our lived experience to realize our hopes and goals and live more satisfying lives.

Every form of psychotherapy has methods to enhance awareness. This reflects the central role of improving the quality of awareness in the process of mental healing. Read the rest of this entry

A GoodTherapy.org News Update

Obsessive-compulsive disorder is a condition fairly well known among mental health professionals and the psychologically-minded public at large. Yet as with so many things, there exist extreme departures from what we’d normally envision of a person afflicted with OCD –and the co-author of a recently released book on the subject is an excellent example. The man, who suffered from the disorder for most of his life, had developed extreme rituals that kept him from leaving his house or carrying out the vast majority of daily tasks; he became unable to bathe himself and spent hours each day carrying out elaborate counting and organizing rituals. That is, until he met the man who would help him triumph over his condition: his psychotherapist.

The two met after the afflicted man’s family called for help, and the psychotherapist, a renowned expert on OCD at the Harvard Medical School, drove three hours to meet and assess the man –and the mind– that would occupy his professional efforts for years to come. That initial meeting was difficult; the young man had developed strict rules for what actions could be taken in his home or around his person, yet psychologist and client were eventually able to find common ground. Read the rest of this entry

© Copyright 2009 by http://www.GoodTherapy.org Therapist Mill Valley Bureau - All Rights Reserved.