Therapeutic Relationship Quotes

In a culture in which interpersonal relationships are generally considered to provide the answer to every form of distress, it is sometimes difficult to persuade well-meaning helpers that solitude can be as therapeutic as emotional support.

the essence of a therapeutic relationship: finding words where words were absent before and, as a result, being able to share your deepest pain and deepest feelings with another human being. This is one of the most profound experiences we can have, and such resonance, in which hitherto unspoken words can be discovered, uttered, and received, is fundamental to healing the isolation of trauma—especially if other people in our lives have ignored or silenced us. Communicating fully is the opposite of being traumatized.

Few see looking after others as therapeutic for the person who does the caretaking, or consider community involvement as therapeutic as drugs. Yet there is mounting evidence that a rich network of face-to-face relationships creates a biological force field against disease.

As connection to the therapist is established, the therapeutic relationship offers an opportunity for the client to experience a present attachment, but it also brings up transferential tendencies associated with past attach ment relationships (Sable, 2000). Informed by the experience of interperesonal trauma and betrayal, posttraumatic transferential relationships can be exceptionally potent and volatile. In response to the therapist, clients experience fear, anger, mistrust, and suspicion, as well as hope, vulnerability, and yearning, and they are acutely attuned to subtle signals of disinterest or interest, compassion or judgment, abandonment or consistency (Herman 1992; Pearlman & Saakvitne, 1995).

Childhood attachments shape the therapeutic relationship in the same way that they form other relationships outside therapy. Those who expect to be loved often make sure others love them, while those who expect to be neglected might evoke neglect.

Given this, the act of revealing oneself fully to another and still being accepted may be the major vehicle of therapeutic help. Others may avoid intimacy because of fears of exploitation, colonization, or abandonment; for them, too, the intimate and caring therapeutic relationship that does not result in the anticipated catastrophe becomes a corrective emotional experience. Hence, nothing takes precedence over the care and maintenance of my relationship to the patient, and I attend carefully to every nuance of how we regard each other.

Like antidepressants, a substantial part of the benefit of psychotherapy depends on a placebo effect, or as Moerman calls it, the meaning response. At least part of the improvement that is produced by these treatments is due to the relationship between the therapist and the client and to the client's expectancy of getting better. That is a problem for antidepressant treatment. It is a problem because drugs are supposed to work because of their chemistry, not because of the psychological factors. But it is not a problem for psychotherapy. Psychotherapists are trained to provide a warm and caring environment in which therapeutic change can take place. Their intention is to replace the hopelessness of depression with a sense of hope and faith in the future. These tasks are part of the essence of psychotherapy. The fact that psychotherapy can mobilize the meaning response - and that it can do so without deception - is one of its strengths, no one of its weaknesses. Because hopelessness is a fundamental characteristic of depression, instilling hope is a specific treatment for it it. Invoking the meaning response is essential for the effective treatment of depression, and the best treatments are those that can do this most effectively and that can do without deception.

Interpersonal neurobiology asks us to place no boundaries on where and how it might illuminate our world. It is possible that every moment has the potential to be therapeutic in some way.

There seems every reason to suppose that the therapeutic relationship is only one instance of interpersonal relations, and that the same lawfulness governs all such relationships. Thus it seems reasonable to hypothesize that if the parent creates with his child a psychological climate such as we have described, then the child will become more self-directing, socialized, and mature.

his understanding of transference in the therapeutic relationship and the presumed value of dreams as sources of insight into unconscious desires. He is commonly referred to as "the father of psychoanalysis" and his work has been highly influential-—popularizing such notions as the unconscious, defense mechanisms, Freudian slips and dream symbolism — while also making a long-lasting impact on fields as diverse as literature (Kafka), film, Marxist and feminist theories, literary criticism, philosophy, and psychology. However, his theories remain controversial and widely disputed. Source: Wikipedia

Following Strupp (1980), clients change when they live through emotionally painful and long-ingrained relational experiences with the therapist, and the therapeutic relationship gives rise to new and better outcomes that are different from those anticipated and feared. That is, when the client re-experiences important aspects of her primary problem with the therapist, and the therapist’s response does not fit the old schemas or expectations, the client has the real-life experience that relationships can be another way. When clients experience this new or reparative response, a response that differs from previous relationships and that does not fit the client’s negative expectations or cognitive schemas, it is a powerful type of experiential re-learning that readily can be generalized to other relationships (Bandura, 1997).

A great many of our patients have conflicts in the realm of intimacy, and obtain help in therapy sheerly through experiencing an intimate relationship with the therapist. Some fear intimacy because they believe there is something basically unacceptable about them, something repugnant and unforgivable, Given this, the act of revealing oneself fully to another and still being accepted may be the major vehicle of therapeutic help.

Though there are many phrases for the therapeutic relationship (patient/therapist, client/counselor, analysand/analyst, client/facilitator, and the latest—and, by far, the most repulsive—user/provider), none of these phrases accurately convey my sense of the therapeutic relationship. Instead I prefer to think of my patients and myself as fellow travelers, a term that abolishes distinctions between “them” (the afflicted) and “us” (the healers).

The educational and therapeutic settings are all about achievement. But that isn't what a relationship with Jesus Christ is about. He loves us exactly as we are and He wants a relationship with us regardless of our performance.

Maybe I should at least wait, to help you, until it’s clear that you want to be helped. Carl Rogers, the famous humanistic psychologist, believed it was impossible to start a therapeutic relationship if the person seeking help did not want to improve.67 Rogers believed it was impossible to convince someone to change for the better. The desire to improve was, instead, the precondition for progress. I’ve had court-mandated psychotherapy clients. They did not want my help. They were forced to seek it. It did not work. It was a travesty.

... every therapist must develop enough personal maturity, clinical wisdom, and capacity for good judgment to effectively and safely conduct psychotherapy, an imperative that is especially important in the treatment of this population. The emotion dysregulation and insecure and disorganized attachment of complex trauma clients elicit strong emotional reactions from others, even those in their support network, including therapists. Reactions can range from sympathy, sorrow, fear, and guilt to frustration, impatience, anger/rage, hostility, and disgust or contempt.

Communication is a vital component of a healthy partnership. It is a necessary foundational aspect of a romantic relationship, as well as a therapeutic one. Yet self-preservation must trump the blind trust of one’s spouse. Particularly when one’s spouse has proved untrustworthy in the past.

Any limiting categorization is not only erroneous but offensive, and stands in opposition to the basic human foundations of the therapeutic relationship. In my opinion, the less we think (during the process of psychotherapy) in terms of diagnostic labels, the better. (Albert Camus once described hell as a place where one’s identity was eternally fixed and displayed on personal signs: Adulterous Humanist, Christian Landowner, Jittery Philosopher, Charming Janus, and so on.8 To Camus, hell is where one has no way of explaining oneself, where one is fixed, classified—once and for all time.)

I should like to point out one final characteristic of these individuals as they strive to discover and become themselves. It is that the individual seems to become more content to be a process rather than a product. When he enters the therapeutic relationship, the client is likely to wish to achieve some fixed state: he wants to reach the point where his problems are solved, or where he is effective in his work, or where his marriage is satisfactory. He tends, in the freedom of the therapeutic relationship to drop such fixed goals, and to accept a more satisfying realization that he is not a fixed entity, but a process of becoming.

Recognizing the power of relationships and relational cues is essential to effective therapeutic work and, indeed, to effective parenting, caregiving, teaching and just about any other human endeavor. This would turn out to be a major challenge as we started working with the Davidian children. Because, as I soon discovered, the CPS workers, law enforcement officers and mental health workers involved in trying to help the children were all overwhelmed, stressed out and in a state of alarm themselves.

Client-therapist disagreement about the goals and tasks of therapy may impair the therapeutic alliance.† This issue is not restricted to group therapy. Client-therapist discrepancies on therapeutic factors also occur in individual psychotherapy. A large study of psychoanalytically oriented therapy found that clients attributed their successful therapy to relationship factors, whereas their therapists gave precedence to technical skills and techniques.84 In general, analytic therapists value the coming to consciousness of unconscious factors and the subsequent linkage between childhood experiences and present symptoms far more than do their clients, who deny the importance or even the existence of these elements in therapy; instead they emphasize the personal elements of the relationship and the encounter with a new, accepting type of authority figure.

In psychoanalysis, when approaching the unconscious—that is, what we do not know—we, patient and analyst alike, are certain to be disturbed. In every consulting-room, there ought to be two rather frightened people: the patient and the psychoanalyst. If they are not both frightened, one wonders why they are bothering to find out what everyone knows.

The relationship between an emotionally intelligent negotiator and their counterpart is essentially therapeutic.

In fact, the same intervention or response may even have the opposite effect on two different clients with contrasting developmental histories and cultural contexts. For example, if a client’s parent was distant or aloof, the therapist’s judicious self-disclosure may be helpful for the client. In contrast, the same type of self-disclosure is likely to be anxiety-arousing for a client who grew up serving as the confidant or emotional caregiver of a depressed parent. Greater sharing with the therapist may help the first client learn that, contrary to her deeply held beliefs, she does matter and can be of interest to other people. In contrast, for the second client, the same type of self-disclosure may inadvertently impose the unwanted needs of others and set this client back in treatment as, in her mind, she experiences herself back in her old caretaking role again—this time with the therapist. This unwanted reenactment occurs because the therapeutic relationship is now paralleling the same problematic relational theme that this client struggled with while growing up.

... the silent client may be experienced as withholding, oppositional, and sulking or as holding the therapist "hostage" in ways that elicit resentment and other negative responses. Because it is not unusual that relational and other forms of traumatization began when the client was preverbal, he or she may not have words. The lack of access to emotions or to words to describe them is known as alexithymia and is a common response to trauma. What the client is likely to have instead is somatosensory, behavioral, dissociative, and relational manifestations that therapists must seek to understand and translate into words, a process that involves hard work and intense focus.

New evidence (2002) indicates that reparative adult experiences enable those with attachment traumas to increase their ability to cope with stress and restore a sense of security. Healing through new relationships occurs frequently, and makes a person who has experienced trauma increase the ability to cope with stress and negative affect. Religious or 12-step experiences, therapeutic experiences, and intimate relationships all offer possibilities for repair.

Periods of relaxed social-sexual mores and less structured romantic relationships (such as in the late 1960s and 1970s) are more difficult for borderlines to handle; increased freedom and lack of structure paradoxically imprison the borderline, who is severely handicapped in devising his own individual system of values. Conversely, the sexual withdrawal period of the late 1980s (due in part to the AIDS epidemic) can be ironically therapeutic for borderline personalities. Social fears enforce strict boundaries that can be crossed only at the risk of great physical harm; impulsivity and promiscuity now have severe penalties in the form of STDs, violent sexual deviants, and so on. This external structure can help protect the borderline from his own self-destructiveness.

The overarching principle of a therapeutic relationship is that therapists should be ever mindful of a variant of the Hippocratic oath and, to the degree possible, strive to "do no more harm" (Courtois, 2010). Complex trauma clients have already experienced considerable harm, much of it at the hands of other human beings. As a result of the ubiquitous processes of transference, attachment styles, and IWM [Internal working models], these clients often view the therapist's behavior and their relationship through the lens of their trauma-related negative interpersonal expectancies and unhealed emotional wounds and injuries. Therapists should not be surprised to be "guilty until proven innocent", not because clients with complex trauma histories are "unfair" or "unreasonable" but precisely the opposite - because the most realistic self-protective stance for them (given the fact that betrayal and harm have been more the rule than the exception) is to "distrust first and verify" (or to be hypervigilant) rather than to start with an expectation of safety and trustworthiness.

At the heart of God is the desire to give and to forgive. Because of this, he set into motion the entire redemptive process that culminated in the cross and was confirmed in the resurrection. The usual notion of what Jesus did on the cross was something like this: people were so bad and so mean and God was so angry with them that he could not forgive them unless somebody big enough took the rap for the whole lot of them. Nothing could be further from the truth. Love, not anger, brought Jesus to the cross. Golgotha came as a result of God’s great desire to forgive, not his reluctance. Jesus knew that by his vicarious suffering he could actually absorb all the evil of humanity and so heal it, forgive it, redeem it. This is why Jesus refused the customary painkiller when it was offered him. He wanted to be completely alert for this greatest work of redemption. In a deep and mysterious way he was preparing to take on the collective sin of the human race. Since Jesus lives in the eternal now, this work was not just for those around him, but he took in all the violence, all the fear, all the sin of all the past, all the present, and all the future. This was his highest and most holy work, the work that makes confession and the forgiveness of sins possible…Some seem to think that when Jesus shouted “My God, my God, why hast thou forsaken me?” it was a moment of weakness (Mark 15:34). Not at all. This was his moment of greatest triumph. Jesus, who had walked in constant communion with the Father, now became so totally identified with humankind that he was the actual embodiment of sin. As Paul writes, “he made him to be sin who knew no sin (2 Cor. 5:21). Jesus succeeded in taking into himself all of the dark powers of this present evil age and defeated every one of them by the light of his presence. He accomplished such a total identification with the sin of the race that he experienced the abandonment of God. Only in that way could he redeem sin. It was indeed his moment of greatest triumph. Having accomplished this greatest of all his works, Jesus then took refreshment. “It is finished,” he announced. That is, this great work of redemption was completed. He could feel the last dregs of the misery of humankind flow through him and into the care of the Father. The last twinges of evil, hostility, anger, and fear drained out of him, and he was able to turn again into the light of God’s presence. “It is finished.” The task is complete. Soon after, he was free to give up his spirit to the father. …Without the cross the Discipline of confession would be only psychologically therapeutic. But it is so much more. It involves and objective change in our relationship with God and a subjective change in us. It is a means of healing and transforming the inner spirit.

I consider therapy successful when the family members (or individual clients) have discovered ways to get what they need from their relationships with the people in their lives, so that their relationship with me is no longer necessary to sustain them. Like a chemical catalyst that facilitates a reaction between two other substances, the therapeutic relationship catalyzes the transformation of relationships in the lives of clients. But the real healing takes place not in the therapeutic relationship but in the client's relationships with significant others.

Therapists have an interesting job. We’re taught that the most crucial component of the therapeutic process is the relationship. The relationship is professional; there are boundaries to maintain, and yet, we’re not machines; we are all human, and we come to truly care about our clients.

If the therapist understands and does not take mistrust as personal affront, the therapeutic relationship can evolve gradually. The client can begin to recognize that the therapist actually "gets" why he or she is initially skeptical, self-protective, or "realistically paranoid" and does not pressure the client to be a "happy camper" but instead works to earn trust by being honorable, reliable, and consistent. This also implies a view of the client's initial mistrust as expectable in light of the client's history - that is, as a strength rather than as a deficiency or pathology.

Existential loneliness and a sense that one's life is inconsequential, both of which are hallmarks of modern civilizations, seem to me to derive in part from our abandoning of belief in the therapeutic dimensions of a relationship with place, a continually refreshed sense of the endless complexity of patterns in the natural world. Patterns that are ever present and discernible, and which incorporate the observer undermines the feeling that one is alone in the world, or meaningless in it.

I believe that all learning is relational. Teachers who try to teach without first having created a positive relationship with their students may only be wasting much of their great knowledge. Establish an encouraging relationship with a child, and you can teach him or her almost anything. Establish a strong therapeutic alliance with your client, and he or she might even be willing to build new neuronal pathways that indicate that trust, love, and unconditional worth are possible for him or her too.

Existential loneliness and a sense that one’s life is inconsequential, both of which are hallmarks of modern civilizations, seem to me to derive in part from our abandoning a belief in the therapeutic dimensions of a relationship with place. A continually refreshed sense of the endless complexity of patterns in the natural world, patterns that are ever present and discernible, and which incorporate the observer, undermines the feeling that one is alone in the world, or meaningless in it. The effort to know a place deeply is, ultimately, an expression of the human desire to belong, to fit somewhere.

An important attribute of metabolites is their close relationship to both the biological states of interest (i.e. disease status) and relevant genomic, transcriptomic, and proteomic variants causally related to the disease state. As such, metabo-profiles can be viewed as an intermediate measure that links pre-disposing genes and environmental exposures to a resulting disease state. Causal metabolites also typically have a stronger relationship (i.e. larger effect size) to the underlying genetics and the disease phenotype. Thus, the integration of metabolomic data into systems biology approaches may provide a missing link between genes and disease states.

There were inquiries, Congressional hearings, books, exposés and documentaries. However, despite all this attention, it was still only a few short months before interest in these children dropped away. There were criminal trials, civil trials, lots of sound and fury. All of the systems—CPS, the FBI, the Rangers, our group in Houston—returned, in most ways, to our old models and our ways of doing things. But while little changed in our practice, a lot had changed in our thinking. We learned that some of the most therapeutic experiences do not take place in “therapy,” but in naturally occurring healthy relationships, whether between a professional like myself and a child, between an aunt and a scared little girl, or between a calm Texas Ranger and an excitable boy. The children who did best after the Davidian apocalypse were not those who experienced the least stress or those who participated most enthusiastically in talking with us at the cottage. They were the ones who were released afterwards into the healthiest and most loving worlds, whether it was with family who still believed in the Davidian ways or with loved ones who rejected Koresh entirely. In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.

The Brits call this sort of thing Functional Neurological Symptoms, or FNS, the psychiatrists call it conversion disorder, and almost everyone else just calls it hysteria. There are three generally acknowledged, albeit uncodified, strategies for dealing with it. The Irish strategy is the most emphatic, and is epitomized by Matt O’Keefe, with whom I rounded a few years back on a stint in Ireland. “What are you going to do?” I asked him about a young woman with pseudoseizures. “What am I going to do?” he said. “I’ll tell you what I’m goin’ to do. I’m going to get her, and her family, and her husband, and the children, and even the feckin’ dog in a room, and tell ’em that they’re wasting my feckin’ time. I want ’em all to hear it so that there is enough feckin’ shame and guilt there that it’ll keep her the feck away from me. It might not cure her, but so what? As long as I get rid of them.” This approach has its adherents even on these shores. It is an approach that Elliott aspires to, as he often tells me, but can never quite marshal the umbrage, the nerve, or a sufficiently convincing accent, to pull off. The English strategy is less caustic, and can best be summarized by a popular slogan of World War II vintage currently enjoying a revival: “Keep Calm and Carry On.” It is dry, not overly explanatory, not psychological, and does not blame the patient: “Yes, you have something,” it says. “This is what it is [insert technical term here], but we will not be expending our time or a psychiatrist’s time on it. You will have to deal with it.” Predictably, the American strategy holds no one accountable, involves a brain-centered euphemistic explanation coupled with some touchy-feely stuff, and ends with a recommendation for a therapeutic program that, very often, the patient will ignore. In its abdication of responsibility, motivated by the fear of a lawsuit, it closely mirrors the beginning of the end of a doomed relationship: “It’s not you, it’s … no wait, it’s not me, either. It just is what it is.” Not surprisingly, estimates of recurrence of symptoms range from a half to two-thirds of all cases, making this one of the most common conditions that a neurologist will face, again and again.

Working with people is basically not a question of formal education; working with people is a question of energy and awareness. Everyone can basically work with people. It is a question of developing a presence and a quality to work from. It is also about discovering our own unique way to be and work with people from our authentic inner being. The most important healing- and therapeutic ability is the capacity to be present. To be present means to develop a presence and a quality to work from. It means to be present with an open and relaxed heart, and to be grounded in our inner being, in the meditative quality within. Presence means to work from a meditative quality, from an inner "yes"-quality, from a state of non-doing. It is to be present for another person as a supporting light, as a supporting presence. Meditation is the way to deepen our capacity to be present, and explore how to bring the meditative presence into the healing- and therapeutic process. It is about developing a meditative presence and quality, to develop the inner "yes"-quality, the silence and emptiness within ourselves, the inner source of healing and wholeness, the capacity to surrender to life.

It is not possible for human beings to outgrow loneliness. Nor can someone from a culture that condescends to nature easily escape the haunting thought that one’s life is meaningless. Existential loneliness and a sense that one’s life is inconsequential, both of which are hallmarks of modern civilizations, seem to me to derive in part from our abandoning a belief in the therapeutic dimensions of a relationship with place. A continually refreshed sense of the unplumbable complexity of patterns in the natural world, patterns that are ever present and discernible, and which incorporate the observer, undermine the feeling that one is alone in the world, or meaningless in it. The effort to know a place deeply is, ultimately, an expression of the human desire to belong, to fit somewhere. The determination to know a particular place, in my experience, is consistently rewarded. And every natural place, to my mind, is open to being known. And somewhere in this process a person begins to sense that they themselves are becoming known, so that when they are absent from that place they know that place misses them. And this reciprocity, to know and be known, reinforces a sense that one is necessary in the world.

One: These losses shape your psyche; they lay down patterns for all your interactions. If you don’t understand them and actively work to form new emotional habits, you’ll act them out again and again. They’ll wreak havoc on your relationships, and you won’t know why. There are many ways to confront them, some of which we’re exploring in this book. Two: No matter how much therapeutic work you do, these may be your Achilles’ heels for life: maybe a fear of abandonment, a fear of success, a fear of failure; maybe deep-seated insecurity, rejection sensitivity, precarious masculinity, perfectionism; maybe hair-trigger rage, or a hard nub of grief you can feel like a knot protruding from your otherwise smooth skin. Even once you break free (and you can break free), these siren songs may call you back to your accustomed ways of seeing and thinking and reacting. You can learn to block your ears most of the time, but you’ll have to accept that they’re always out there singing. The third answer is the most difficult one to grasp, but it’s also the one that can save you. The love you lost, or the love you wished for and never had: That love exists eternally. It shifts its shape, but it’s always there. The task is to recognize it in its new form.

Should you operate upon your clients as objects, you risk reducing them to less than human. Following the culture of appropriation and mastery your clients become a kind of extension of yourself, of your ego. In the appropriation and objectification mode, your clients’ well-being and success in treatment reflect well upon you. You “did” something to them, you made them well. You acted upon them and can take the credit for successful therapy or treatment. Conversely, if your clients flounder or regress, that reflects poorly on you. On this side of things the culture of appropriation and mastery says that you are not doing enough. You are not exerting enough influence, technique or therapeutic force. What anxiety this can breed for some clinicians! DBT offers a framework and tools for a treatment that allows clients to retain their full humanity. Through the practice of mindfulness, you can learn to cultivate a fuller presence to the moments of your life, and even with your clients and your work with them. This presence potentiates an encounter between two irreducible human beings, meeting professionally, of course, and meeting humanly. The dialectical framework, which embraces contradictions and gives you a way of seeing that life is pregnant with creative tensions, allows for your discovery of your limits and possibilities, gives you a way of seeing the dynamic nature of reality that is anything but sitting still; shows you that your identity grows from relationship with others, including those you help, that you are an irreducible human being encountering other irreducible human beings who exert influence upon you, even as you exert your own upon them. Even without clinical contrivance.

• No matter how open we as a society are about formerly private matters, the stigma around our emotional struggles remains formidable. We will talk about almost anyone about our physical health, even our sex lives, but bring depression, anxiety or grief , and the expression on the other person would probably be "get me out of this conversation" • We can distract our feelings with too much wine, food or surfing the internet, • Therapy is far from one-sided; it happens in a parallel process. Everyday patients are opening up questions that we have to think about for ourselves, • "The only way out is through" the only way to get out of the tunnel is to go through, not around it • Study after study shows that the most important factor in the success of your treatment is your relationship with the therapist, your experience of "feeling felt" • Attachment styles are formed early in childhood based on our interactions with our caregivers. Attachment styles are significant because they play out in peoples relationships too, influencing the kind of partners they pick, (stable or less stable), how they behave in a relationship (needy, distant, or volatile) and how the relationship tend to end (wistfully, amiably, or with an explosion) • The presenting problem, the issue somebody comes with, is often just one aspect of a larger problem, if not a red herring entirely. • "Help me understand more about the relationship" Here, here's trying to establish what’s known as a therapeutic alliance, trust that has to develop before any work can get done. • In early sessions is always more important for patients to feel understood than it is for them to gain any insight or make changes. • We can complain for free with a friend or family member, People make faulty narratives to make themselves feel better or look better in the moment, even thought it makes them feel worse over time, and that sometimes they need somebody else to read between the lines. • Here-and-now, it is when we work on what’s happening in the room, rather than focusing on patient's stories. • She didn't call him on his bullshit, which this makes patients feel unsafe, like children's whose parent's don’t hold them accountable • What is this going to feel like to the person I’m speaking to? • Neuroscientists discovered that humans have brain cells called mirror neurons, that cause them to mimic others, and when people are in a heightened state of emotion, a soothing voice can calm their nervous system and help them stay present • Don’t judge your feelings; notice them. Use them as your map. Don’t be afraid of the truth. • The things we protest against the most are often the very things we need to look at • How easy it is, I thought, to break someone’s heart, even when you take great care not to. • The purpose on inquiring about people's parent s is not to join them in blaming, judging or criticizing their parents. In fact it is not about their parents at all. It is solely about understanding how their early experiences informed who they are as adults so that they can separate the past from the present (and not wear psychological clothing that no longer fits) • But personality disorders lie on a spectrum. People with borderline personality disorder are terrified of abandonment, but for some that might mean feeling anxious when their partners don’t respond to texts right away; for others that may mean choosing to stay in volatile, dysfunctional relationships rather than being alone. • In therapy we aim for self compassion (am I a human?) versus self esteem (Am I good or bad: a judgment) • The techniques we use are a bit like the type of brain surgery in which the patient remains awake throughout the procedure, as the surgeons operate, they keep checking in with the patient: can you feel this? can you say this words? They are constantly calibrating how close they are to sensitive regions of the brain, and if they hit one, they back up so as not to damage it.

According to Freud, these feelings (which he called "transference love") are generated by the therapeutic process itself; they are not the same as love experienced outside the therapy and they have little to do with the particular attributes of the therapist per se. Instead it is a process in which the therapist purposefully induces trust and intimacy in order to (1) analyze the patient's response and (2) use the relationship to influence the patient's response to treatment. Transference, used properly, is a constructive tool in psychotherapy, allowing the therapist to understand where and how particular conflicts developed and how they continue to affect the patient in her adult life. When the transference is understood by the patient as well, it can contribute significantly to the healing process.

There is no evidence from anywhere in the world that harm reduction measures encourage drug use. Denying addicts humane assistance multiplies their miseries without bringing them one inch closer to recovery. There is also no contradiction between harm reduction and abstinence. The two objectives are incompatible only if we imagine that we can set the agenda for someone else’s life regardless of what he or she may choose. We cannot. Short of extreme coercion there is absolutely nothing anyone can do to induce another to give up addiction, except to provide the island of relief where contemplation and self-respect can, perhaps, take root. Those ready to choose abstinence should receive every possible support — much more support than we currently provide. But what of those who don’t choose that path? The impossibility of changing other people is not restricted to addictions. Try as we may to motivate another person to be different or to do this or not to do that, our attempts founder on a basic human trait: the drive for autonomy. “And one may choose what is contrary to one’s own interests and sometimes one positively ought,” wrote Fyodor Dostoevsky in Notes from the Underground. “What man wants is simply independent choice, whatever that independence may cost and wherever it may lead.” The issue is not whether the addict would be better off without his habit — of course he would — but whether we are going to abandon him if he is unable to give it up. Are we willing to care for human beings who suffer because of their own persistent behaviours, mindful that these behaviours stem from early life misfortunes they had no hand in creating? The harm reduction approach accepts that some people — many people — are too deeply enmeshed in substance dependence for any realistic “cure” under present circumstances. There is, for now, too much pain in their lives and too few internal and external resources available to them. In practising harm reduction we do not give up on abstinence — on the contrary, we may hope to encourage that possibility by helping people feel better, bringing them into therapeutic relationships with caregivers, offering them a sense of trust, removing judgment from our interactions with them and giving them a sense of acceptance. At the same time, we do not hold out abstinence as the Holy Grail and we do not make our valuation of addicts as worthwhile human beings dependent on their making choices that please us. Harm reduction is as much an attitude and way of being as it is a set of policies and methods.

A child’s play both demands and creates its own safe space, one in which she can confront threats, fears, and dangers—but always come through whole. In this sense, play can be therapeutic. In play everything that goes on gets suspended in an “as if” reality.

The increased awareness offered by psychedelics comes in different forms. In higher doses taken in safe and sacred settings, they facilitate recognition of one’s intimate relationship with all living things. In moderate doses, they facilitate awareness of the intricate psychodynamic structures of one’s individual consciousness. In low doses, they facilitate awareness of solutions to technical and artistic problems.

When the emotional climate in the therapeutic relationship is “too hot”, which can be due to aggression, fear or anxiety, the task of the therapist is to reduce intensity. The state of arousal inhibits mentalizing, and hence therapy cannot proceed satisfactorily. If it is “too cold”, in the meaning of detachment and polite talk, the mission is to make the encounter warmer and more engaged. Often when working with eating disorders, we experience the usefulness of activating affects, making cold warmer.

began this book by observing that death anxiety rarely enters the discourse of psychotherapy. Therapists avoid the topic for a number of reasons: they deny the presence or the relevance of death anxiety; they claim that death anxiety is, in fact, anxiety about something else; they may fear igniting their own fears; or they may feel too perplexed or despairing about mortality. I hope that I have, in these pages, conveyed the necessity and the feasibility of confronting and exploring all fears, even the darkest ones. But we need new tools-a different set of ideas and a different type of therapist-patient relationship. I suggest that we attend to the ideas of great thinkers who have faced death forthrightly and that we build a therapeutic relationship based on the existential facts of life. Everyone is destined to experience both the exhilaration of life and the fear of mortality.

One example of taking a male-friendly approach [in therapy] is the view that traditional masculinity is not the root cause of men’s mental health problems, and, in fact, might contain valuable resources that can enhance mental health. This viewpoint allows therapists to understand men in a way that is more likely to foster better rapport between therapist and client, facilitating a more successful therapy.

No matter what therapeutic approach is provided, if the relationship between therapist and client is not established or is perceived by the client as problematic, then it is unlikely that the therapy will be successful.

Without the cross the Discipline of confession would be only psychologically therapeutic. But it is so much more. It involves an objective change in our relationship with God and a subjective change in us. It is a means of healing and transforming the inner spirit.

We learned that some of the most therapeutic experiences do not take place in “therapy,” but in naturally occurring healthy relationships, whether between a professional like myself and a child, between an aunt and a scared little girl, or between a calm Texas Ranger and an excitable boy. The children who did best after the Davidian apocalypse were not those who experienced the least stress or those who participated most enthusiastically in talking with us at the cottage. They were the ones who were released afterwards into the healthiest and most loving worlds, whether it was with family who still believed in the Davidian ways or with loved ones who rejected Koresh entirely. In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.

The intention of acceptance is to allow for complexity. As humans, we are faced with managing an extremely complex world. Preconceived knowledge, beliefs, and agendas are often used to manage the complexity of the therapeutic process, but they can also get in our way of being present and open to the direct experience with our clients. To truly understand another’s internal world, we have to free ourselves from what we believe we know, to the best of our abilities, so as to be able to make real contact. Once we can say “I don’t know,” we can be open to new learning and greater complexity. As philosopher Jiddu Krishnamurti taught, “You can learn only if you do not know.”4 The reality is that we will never fully know our client’s internal experience, but we can continue to learn as we deepen into relationship with them.

in order to understand how they relate to the past, the search for recurring patterns, and a focus on the therapeutic relationship to see how conflicts are repeated.

Family therapists view the therapeutic relationship as a means to an end rather than as an end in itself. Family therapists see beyond the problematic patterns in the family to the potential healing power of family relationships.

client openness versus defensiveness, change talk versus sustain talk, is very much a product of the therapeutic relationship. “Resistance” and motivation occur in an interpersonal context.

There is no evidence of spontaneous remission or integration of personality alters without mental health treatment. Therapy is long-term and requires the establishment of a strong therapeutic relationship with the individual.

In order to change, however, you have to be willing to acknowledge the need for change—in other words, you have to come to terms with the fact that everything in your life isn’t perfect. There is this concept—among not just Scientologists, but everyone—that we are all supposed to have it together. Whether it’s our work, love lives, family relationships, or even feelings about ourselves, we need to present this idealized image to others. We are so conditioned when asked “How are you?” to say “Good” or “Great.” But why not “I don’t know. I hate everyone today.” Why are we so scared to be judged imperfect or to talk about how we really feel? To be authentic? If we can just tell each other how and what we are really doing, step outside of what we believe others think we should be, the result can be therapeutic.

The view that relationships with a therapeutic quality provide a wholeness-growing environment is implicit in the rich Hebrew word shalom and its equivalent Arabic word salaam. These words, most frequently translated “peace,” also mean sound, healthy, or wholeness. Shalom or salaam is cultivated in Spirit-empowered communities where the quality of relationships provides a nurturing environment. In fact, in the New Testament Greek, koinonia is used to describe the church as a healing, transforming community enlivened by God’s spirit.

The narcissistic gratifications involved in psychoanalytic training, such as professional advancement, the unconscious misuse of the therapeutic relationship as an expression of power, basking in patients’ idealizations, and the facilitation of vicarious living through patients may unfortunately remain unrecognized for many years. The

We learned that some of the most therapeutic experiences do not take place in “therapy,” but in naturally occurring healthy relationships, whether between a professional like myself and a child, between an aunt and a scared little girl, or between a calm Texas Ranger and an excitable boy. The children who did best after the Davidian apocalypse were not those who experienced the least stress or those who participated most enthusiastically in talking with us at the cottage. They were the ones who were released afterwards into the healthiest and most loving worlds, whether it was with family who still believed in the Davidian ways or with loved ones who rejected Koresh entirely. In fact, the research on the most effective treatments to help child trauma victims might be accurately summed up this way: what works best is anything that increases the quality and number of relationships in the child’s life.

The R in NARM is about the therapeutic relationship, which includes both client and therapist. NARM is an approach based in intersubjectivity. This process invites the possibility of deepening connection to Self and others. As we teach in NARM—and will detail throughout this book—connection is both our deepest desire and greatest fear.

What Rhymes with Therapy" is a unique self-help book that offers psychological guidance for depression, anxiety, grief, anger, trauma recovery, and relationship issues. The book’s distinction is that the guidance is written in the language of rhythm-and-rhyme poetry. Each poem comes complete with a full description of the therapeutic intervention and exercises that can be used to implement the ideas into real life.

We’re more able to do the therapeutic work involved in grieving old wounds, uncovering core beliefs, and establishing new ways of being. Having relationships that create new, healthier patterns can change our expectations and attitudes and give us a new foundation from which to work.

That is the aim of this therapeutic relationship: to feel the emotions that he can’t feel – to recommune the person whose trauma has placed him outside of human communion.

The capacity to be alone is a valuable resource when changes of mental attitude are required. After major alterations in circumstances, fundamental reappraisal of the significance and meaning of existence may be needed. In a culture in which interpersonal relationships are generally considered to provide the answer to every form of distress, it is sometimes difficult to persuade well-meaning helpers that solitude can be as therapeutic as emotional support.

Despite their eye-rolling, ear-plugging, and other superficial resistance, teenagers consistently say that they do want such information from parents, and that they benefit from it. I know from experience that's true: boys often told me that our conversations had a dramatic, ongoing, sometimes therapeutic, impact- and I was a total stranger. So rather than fixating on how discussing physical and emotional intimacy makes you- and your son- want to sink into the earth, consider the opportunity it creates for a closer relationship, to show him that you are genuinely there for him, to display openness, strength, and perseverance in the face of messy realities.

Many draw unforgiving boundaries against their family members and friends who cannot transform their selves—overcome addictions, save money, heal troubled relationships—through sheer determination alone,” writes Silva in her book Coming Up Short: Working-Class Identity in an Age of Uncertainty. “[A]t the center of the therapeutic coming of age narrative are not more traditional sources of identity such as work, religion, or gender, but instead the family—as the source of one’s individuality, the source of the self, and the source of the neuroses from which one must liberate oneself.

By having disconnected ourselves emotionally from the Earth and plants we have lost our understanding of those links and mutual relationships,” writes Stephen Harold Buhner.4

Traditionally, the therapeutic culture has favored the spoken word over the expressiveness of the body. Yet sexuality and emotional intimacy are two separate languages. I would like to restore the body to its rightful prominent place in discussions about couples and eroticism. The body often contains emotional truths that words can too easily gloss over. The very dynamics that are a source of conflict in a relationship—particularly those pertaining to power, control, dependency, and vulnerability—often become desirable when experienced through the body and eroticized. Sex becomes both a way to illuminate conflicts and confusion around intimacy and desire and a way to

Schore emphasized that when the caregiver is unable to help the child to regulate either a specific emotion or intense emotions in general, or – worse – that she exacerbates the dysregulation, the child will start to go into a state of hypoaroused dissociation as soon as a threat of dysregulation arises. This temporaily reduces conscious emotional pain in the child living with chronic trauma, but those who characterologically use the emotion-deadening defense of dissociation to cope with stressful interpersonal events subsequently dissociate to defend against both daily stresses, and the stress caused when implicitly held memories of trauma are triggered. In the developing brain, repeated neurological states become traits, so dissociative defense mechanisms are embedded into the core structure of the evolving personality, and become a part of who a person is, rather than what a person does. Dissociation, which appears in the first month of life, seems to be a last resort survival strategy. It represents detachment from an unbearable situation. The infant withdraws into an inner world, avoids eye contact and stares into space. Dissociation triggered by a hypoaroused state results in a constricted state of consciousness, and a void of subjectivity. Being cut off from our emotions impacts our sense of who we are as a person. Our subjective sense of self derives from our unconscious experience of bodily-based emotions and is neurologically constructed in the right brain. If we cannot connect to our bodily emotions then our sense of self is built on fragile foundations. Many who suffered early relational trauma have a disturbed sense of their bodies and of what is happening within them physiologically as well as emotionally. The interview moved along to the topic of how we can possibly master these adverse and potentially damaging relational experiences. Schore replied by explaining that the human brain remains plastic and capable of learning throughout the entire life span, and that with the right therapeutic help and intervention we can move beyond dissociation as our primary defense mechanism, and begin to regulate our emotions more appropriately. When the relationship between the therapist and the client develops enough safety, the therapeutic alliance can act as a growth-facilitating environment that offers a corrective emotional experience via “rewiring” the right brain and associated neurocircuits.

right brain and associated neurocircuits. This is predicated on the formation of a trusting relationship between the patient and therapist, who must be sensitive enough to receive the patient’s underlying negative state, and implicitly empathically resonate with what is going on within the client’s right brain and within his body. All therapeutic techniques sit on top of the therapist’s ability to access the implicit realm via right-brain-to-right-brain communications. A strong therapeutic alliance depends on the therapist’s knowledge about the patient from the inside out, rather than from the top down. The patient’s emotional growth depends on the therapist’s ability to move, and to be moved by, those that come to him for help. The therapist has to help patients to learn how to regulate feeling associated with trauma so that the patient can integrate them into his emotional life, rather than having to dissociate when they arise. When a patient is catapulted into a hyperaroused state and subjectively experiences the therapist through the lens of the previous insecure internal working models, this is the expression of “negative transference.” For a patient who is in the midst of a negative transference the therapeutic alliance is severely ruptured, and the therapist is seen as an analogue of the early misattuned other and is experienced as source of dysregulation rather than interactive regulation. However, if the therapist can maintain an attuned connection to the client, then the door opens to working with what was laid down early in the patient’s life and reorganization becomes a possibility. A problem may arise if the therapist cannot contain the negative emotions created in negative transference and in projective identification. There is an old adage in therapy that no patient can achieve a greater level of healing than the therapist has achieved. With modern scientific knowledge we can be more specific: the patient’s unconscious right brain can develop only as far as the therapist’s right brain can take them. For a therapist to stay with a dissociating patient who is projecting his trauma onto

final problem of cognitive therapy is that it is generally a short-term treatment so it is unable to build a strong enough therapeutic alliance to allow the patient to experience the corrective emotional experience. Deep change does not happen when a patient is consciously reflecting on an emotion. Rather it happens when the patient actively experiences the emotion and when a resonating emotionally present therapist recognizes and regulates that emotion, thereby modeling new ways of being with another while one is under stress. There is no interpersonal space for this repair of attachment ruptures in current models of cognitive therapy, where left brain insight dominates over right brain interactive regulation. Coming to the end, Sieff asked Schore what message he would like people to take home from this interview. Schore answered that the earliest stages of life are critical as they form the foundation of everything that follows. Our early attachment relationships, for better or worse, shape our right brain unconscious system and have lifelong consequences. An attuned early attachment relationship enables us to grow an interconnected, well-developed right brain and sets us up to become secure individuals, open to new social and emotional experiences. A traumatic early attachment relationship impairs the development of a healthy right brain and locks us into an emotionally dysregulated, amygdala-driven emotional world. As a result, our only way to defend against intense unregulated emotions is via the over reliance on repression and/or pathological characterological dissociation. Faced with relational stress, we are cut off from the world, from other people, from our emotions, from our bodies and from our sense of self. Our right brains cannot further develop or grow emotionally from our interactions with other right brains. Too many people suffer alone with their desperate pain due to their early relational trauma. For somebody struggling with such emotional dysregulation, the way to emotional security, and to a more vital, alive, and fulfilling life, does not come from making the unconscious conscious – which is essentially a left brain process

If I could get across to Dibs my confidence in him as a person who had good reasons for everything he did, and if I could convey the concept that there were no hidden answers for him to guess, no concealed standards of behavior or expression that were not openly stated, no pressure for him to read my mind and come up with a solution that I had already decided upon, no rush to do everything today—then, perhaps, Dibs would catch more and more of a feeling of security and of the rightness of his own actions so he could clarify, understand, and accept them. This would take time, real effort, great patience on the part of both of us. And it must at all times be basically and fundamentally honest.

Writing is therapeutic, Ultimate Catharsis… Venting tool. Exploring a world on your own terms…

With the cultural portrayal of the smallest details of existence, the distance between one's experience and one's perceptions of it becomes enlarged by a vast interpretive network by this ubiquitous cultural network, the experience must be denied. This process, of course, does not apply only to women. The pervasion of image has so deeply altered our very relationships to ourselves that even men have become objects - if never erotic objects. Images become extensions of oneself; it gets hard to distinguish the real person from his latest image, if indeed, the Person Underneath hasn't evaporated altogheter. [...] each image hitting new highs of sophistication until the person himself doesn't know who he is. Moreover, he deals with others through this image-extension. (Boy-Image meets Girl-Image and consumattes Image-Romance). Even if a woman could get beneath this intricate image facade - and it would take months, even years, of a painful, almost therapeutic relationship - she would be met not with gratitude that she had (painfully) loved the man for his real self, but with shocked repulsion and terror that she had found him out.

But there is another, more dynamic and less hidebound way to interpret love: as a particular kind of education. In this view, a relationship essentially comprises a mutual attempt to learn from and teach something to another person. We are drawn to our partners because we want to be educated by them and vice versa. We love them because we see in them things that we long for that are missing in us; we aspire to grow under the tutelage of love.

Our requests to our lovers might sound as follows: I need you to accept—often and readily—the possibility that you might be at fault, without this feeling to you like the end of the world. You have to allow that I can have a legitimate criticism and still love you. I need you to be undefensive. I need you to own up to what you are embarrassed or awkward about in yourself. I need you to know how to access the younger parts of you without terror. I need you to be able to be vulnerable around me. I need you to respond warmly, gently, and compassionately to the fragile parts of who I am; to listen to, and understand, my sorrows. We need a union of mutual tenderness. I need you to have a complex, nuanced picture of me and to understand the emotional burdens I’m carrying, even though I wish I weren’t, from the past. You have to see me with something like the generosity associated with therapy. I need you to regularly air your disappointments and irritations with me—and for me to do the same with you—so that the currents of affection between us can remain warm and our capacity for admiration intense. If these five critical demands have been met, we will feel loved and essentially satisfied whatever differences then crop up in a hundred other areas. Perhaps our partner’s friends or routines won’t be a delight, but we will be content. Just as if we lack these emotional goods, and yet agree on every detail of European literature, interior design, and social existence, we are still likely to feel lonely and bereft. By limiting what we expect a relationship to be about, we can overcome the tyranny and bad temper that bedevil so many lovers. A good, simpler—yet very fulfilling—relationship could end up in a minimal state. We might not socialize much together. We might hardly ever encounter each other’s families. Our finances might overlap only at a few points. We could be living in different places and only meet up twice a week. Conceivably we might not even ask too many questions about each other’s sex life. But when we do come together it would be profoundly gratifying, because we would be in the presence of someone who knew how to be kind, vulnerable, and understanding. A bond between two people can be deep and important precisely because it is not played out across all practical details of existence. By simplifying and clarifying what a relationship is for, we release ourselves from overly complicated conflicts and can focus on making sure our urgent underlying needs are sympathized with, seen, and understood.

As unpredictable as the content of the LSD reaction is its intensity; the individual responses to the same dosage level vary considerably. My experience indicates that the degree of sensitivity or resistance to LSD depends on complicated psychological factors rather than on variables of a constitutional, biological, or metabolic nature. Subjects who in everyday life have the need to maintain full self-control and have difficulties in relaxing and “letting go” can sometimes resist relatively high dosages of LSD (300 to 500 micrograms) and show no detectable changes. Occasionally, a person can resist a considerable dose of LSD if he has set this as a personal task for himself for any reason. He may decide to do this to defy the therapist and compete with him, to demonstrate his “strength” to himself and to others, to endure more than his fellow patients, or for many other reasons. Usually, however, more relevant unconscious motives can be found underlying such superficial rationalizations. Another cause for a high resistance to the effect of the drug may be insufficient preparation, instruction, and reassurance of the subject, a lack of his full agreement and cooperation, or absence of basic trust in the therapeutic relationship. In this case, the LSD reaction sometimes does not take its full course until the motives of resistance are analyzed and understood. Occasional sudden sobering, which can occur at any period of the session and on any dosage level, can be understood as a sudden mobilization of defenses against the emergence of unpleasant traumatic material. Among psychiatric patients, severe obsessive-compulsive neurotics are particularly resistant to the effect of LSD. It has been a common observation in my research that such patients can resist dosages of more than 500 micrograms of LSD and show only slight signs of physical or psychological distress. In extreme cases, it can take several dozen high-dose LSD sessions before the psychological resistances of these individuals are reduced to the point that they start having episodes of regression to childhood and become aware of the unconscious material that has to be worked through.

Honesty is a love-preserving mechanism that keeps alive all that is impressive and delightful about our partner in our eyes. By regularly voicing our small sorrows and minor irritations, we are scraping the barnacles off the keel of our relationship and thereby ensuring that we will sail on with continued joy and admiration into an authentic and unresentful future. 2 Love and Psychotherapy Lovers and psychotherapists might, at first glance, seem to

The drama of age regression and incest recapitulation (or, for that matter, any therapeutic cathartic or intellectual project) is healing only because it provides therapist and patient with some interesting shared activity while the real therapeutic force—the relationship—is ripening on the tree.

Relationship elements with the strongest correlation to successful therapeutic outcomes (Norcross, 2010) Useful questions for building relationships at an individual and team level

Relationship elements with the strongest correlation to successful therapeutic outcomes (Norcross, 2010) Useful questions for building relationships at an individual and team level Empathy “Involves entering the private, perceptual world of the other” and “communicating that understanding back to the client in ways that can be received and appreciated” (p. 118). How well do you really listen (listening like they are the most important person in the world)? Do you listen to the whole person (beyond their words)? How well do you sensitively communicate back your understanding of how you think the other person is feeling (feeling with another)? Alliance “The quality and strength of the collaborative relationship” (p. 120) How strong is your emotional bond to the other person? What can you do to strengthen it? What could be getting in the way of a stronger bond? Cohesion (in groups) “The forces that cause members to remain in the group” (p. 121) How do you help the team develop cohesion? What do you do that decreases team cohesion? What could you do more of to develop team cohesion? Goal Consensus and Collaboration “The therapist and client journey together toward a mutual destination” (p. 122) Does the relationship have a joint overriding purpose from which goals can be derived? What do you want to achieve together that you cannot do separately? What would success for this relationship look like? Adapted from Norcross (2010: 118–25)

Everything has mind in the lead, has mind in the forefront, is made by the mind,” the Buddha said 2,500 years ago. I return to this phrase of the great teacher Gautama because it is key to understanding our relationship to what we consider real. It is also the bedrock of the therapeutic approach I take to my work and, when I am conscious, to my personal path. With our minds we construct the world we live in: this is the core teaching. The contribution of modern psychology and neuroscience has been to show how, before our minds can create the world, the world creates our minds. We then generate our world from the mind the world instilled in us before we had any choice in the matter. The world into which we were born, of course, was partly the product of other people’s minds, a causal daisy chain dating back forever.

Going to therapy and talking about healing may just be the go-to flex of our time. It is supposedly an indicator of how profoundly self-aware, enlightened, emotionally mature, or “evolved” an individual is. Social media is obsessed and saturated with pop psychology and psychiatry content related to “healing”, trauma, embodiment, neurodiversity, psychiatric diagnoses, treatments alongside productivity hacks, self-care tips and advice on how to love yourself without depending on anyone else, cut people out of your life, manifest your goals to be successful, etc. Therapy isn’t a universal indicator of morality or enlightenment. Therapy isn’t a one-size-fits-all solution that everyone must pursue. There are many complex political and cultural reasons why some people don’t go to therapy, and some may actually have more sustainable support or care practices rooted in the community. This is similar to other messaging, like “You have to learn to love yourself first before someone else can love you”. It all feeds into the lie that we are alone and that happiness comes from total independence. Mainstream therapy blames you for your problems or blames other people, and often it oscillates between both extremes. If we point fingers at ourselves or each other, we are too distracted to notice the exploitative systems making us all sick and sad. Oftentimes, people come out of therapy feeling fully affirmed and unconditionally validated, and this ego-caressing can feel rewarding in the moment even if it doesn’t help ignite any growth or transformation. People are convinced that they can do no wrong, are infallible, incapable of causing harm, and that other people are the problem. Treatment then focuses on inflating self-confidence, self-worth, self-acceptance, and self-love to chase one’s self-centered dreams, ambitions, and aspirations without taking any accountability for one’s own actions. This sort of individualistic therapeutic approach encourages isolation and a general mistrust of others who are framed as threats to our inner peace or extractors of energy, and it further breeds a superiority complex. People are encouraged to see relationships as accessories and means to a greater selfish end. The focus is on what someone can do for you and not on how to give, care for, or show up for other people. People are not pushed to examine how oppressive conditioning under these systems shows up in their relationships because that level of introspection and growth is simply too invalidating. “You don’t owe anyone anything. No one is entitled to your time and energy. If anyone invalidates you and disturbs your peace, they are toxic; cut them out of your life. You don’t need that negativity. You don’t need anyone else; you alone are enough. Put yourself first. You are perfect just the way you are.” In reality, we all have work to do. We are all socialized within these systems, and real support requires accountability. Our liberation is contingent on us being aware of our bullshit, understanding the values of the empire that we may have internalized as our own, and working on changing these patterns. Therapized people may fixate on dissecting, healing, improving, and optimizing themselves in isolation, guided by a therapist, without necessarily practicing vulnerability and accountability in relationships, or they may simply chase validation while rejecting the discomfort that comes from accountability. Healing in any form requires growth and a willingness to practice in relationships; it is not solely validating or invalidating; it is complex; it is not a goal to achieve but a lifelong process that no one is above; it is both liberating and difficult; it is about acceptance and a willingness to change or transform into something new; and ultimately, it is going to require many invalidating ego deaths so we can let go of the fixation of the “self” to ease into interdependence and community care.

Natural Ways to Help Depression Depression is not one illness. Like anxiety, the pandemic spawned a whole new level of people being diagnosed with depression and placed on antidepressant medication, without ever getting a proper evaluation or trying simple fixes. Here are nine common things I do for patients before prescribing antidepressant medication. 1. Check for and (if necessary) correct thyroid hormone abnormalities. 2. Work with a nutritionally informed physician to optimize your folate, vitamin B12, vitamin D, homocysteine, and omega-3 fatty acids. I’m convinced that without doing these nutritional fixes, patients are less likely to respond to the medications. 3. Try an elimination diet for three weeks. 4. Add colorful fruits and vegetables into your diet. 5. Eliminate the ANTs (automatic negative thoughts). See days 22, 116–117. 6. Exercise—walk like you are late for 45 minutes four times a week. This has been found to be as effective as antidepressant medication.[1] 7. Add one of the following supplements to your daily routine: Saffron 30 mg/day; curcumin, not as turmeric root but as Longvida, which is much more efficiently absorbed; zinc as citrate or glycinate 30 mg (tolerable upper level is 40 mg/day for adults, 34 mg/day for adolescents, less for younger kids); or magnesium glycinate, citrate, or malate, 100–500 mg with 30 mg of vitamin B6. 8. Consume probiotics daily. 9. Try morning bright light therapy with a therapeutic lamp of 10,000 lux for 20–30 minutes. If someone comes to me with depression, I order screening labs, teach them not to believe every negative thought they have, give them basic supplements (saffron, zinc, curcumins, and omega-3s), and encourage them to exercise. Many people never need medication if they follow through with the program. If the above interventions are ineffective, I’ll try other nutraceuticals or medications targeted to their specific type of depression (take the test at brainhealthassessment.com).

Clever, funny and often endearing, Charlotte was also capable of fathomless spite, not to mention a self-destructive recklessness that had led her to sever relationships on a whim or to take extreme physical risks. Various psychiatrists and therapists had had their say over the years, each trying to corral her unpredictability and unhappiness into some neat medical classification. She’d been prescribed drugs, ricocheted between counsellors and been admitted to therapeutic facilities, yet Strike knew something in Charlotte herself had stubbornly resisted help.

Aside from offering therapeutic comfort and therapeutic insight, therapy also becomes a performative practice where patients actively reflect on their own power and their relationship to the ongoing project of an unfinished democracy.

There is no more underrated and research-backed therapeutic tool than walking. It reduces back pain, and body pain in general, through dozens of mechanisms. Studies show that walking does the following: Increases circulation of natural opioids in the body175 Reduces pain sensitivity176 Stimulates production and circulation of synovial fluid within joints177 Improves lumbar (low back) function178 Strengthens foot muscles, creating a more stable and pliable base for the hips, back, and neck (especially in minimalist shoes)179 Reduces perceived pain levels, improves blood pressure, and strengthens feelings of personal power180 (if you walk with upright posture instead of slumped) Reduces bone density loss with age, helping to prevent osteoporosis and reduce osteoarthritis pain181 Is a surprisingly effective weight loss and weight management technique, which in turn keeps overall compression forces on joints down182 Increases blood flow to spinal muscles, improving oxygen and nutrient delivery required for cellular healing183 Speeds up elimination of cellular waste products through the repeated contractions of various muscle groups throughout the body183 Reduces the levels of the stress hormone, cortisol, which has a correlative relationship with subjective pain levels184 (Barefoot walking) Improves body awareness and wound healing, reduces inflammation, and helps prevent chronic inflammatory diseases185 Walking doesn’t just help relieve back pain—it targets the central causes of pain. And as you can see from the many studies on walking and pain relief, the benefits are not limited to the locomotion of walking. It’s movement in general that increases circulation of natural opioids, reduces pain sensitivity, stimulates synovial fluid production, and supports cellular health.

According to Scripture, the heart can be significantly changed only by establishing and developing a personal relationship with God (and secondarily with other humans). Correspondingly, our first criterion in assessing current psychological theories will be the extent to which their preferred mode of treatment focuses on personal relationships. The second criterion will be the actual therapeutic results of each method in terms of inner growth and maturation. The third criterion will be the emphasis each theory places on the “being” of the counselor—how counselors relate to their clients is ultimately more important than what they know or do.

In addition to increasing empathy, neurobiological research proves that reading fiction changes the biology of the brain, making it more receptive and connected. Reading novels also makes you more creative and open-minded, gives you psychological courage, and keeps your brain active and healthy. The therapeutic value of reading novels is so profound that it has birthed something called bibliotherapy, in which clients are matched with a literary fiction designed to address what is ailing them, from mild depression to a troubled intimate relationship to a desire to find a work/ family balance. Anyone who belongs to a book club has likely experienced a version of fiction's healing powers. The value of reading is even more significant if you're a writer. Imagine being a chef who eats only chicken nuggets, a carpenter who refuses to look at buildings, or an orchestra conductor who doesn't listen to anything but commercial jingles. Such is the problem for a writer who doesn't read regularly and widely.

Ruesch (1948) discovered that somatically ill patients with a disturbance in verbal and symbolic expression of affect did not benefit from traditional insight-oriented psychotherapy. He advocated a modified psychotherapy usually lasting several years, which included educating the patients about their deficits, drawing attention to emotional cues such as vague bodily sensations, and teaching tolerance of feelings and a capacity for symbolic expression. Ruesch emphasized the importance of the therapeutic relationship and described the approach as similar to child psychotherapy; he advised therapists to be approachable, consistent, explicit, unconditionally accepting of the patient, and to express their own feelings.

Helen’s discovery of language with the help of Anne Sullivan captures the essence of a therapeutic relationship: finding words where words were absent before and, as a result, being able to share your deepest pain and deepest feelings with another human being. This is one of the most profound experiences we can have, and such resonance, in which hitherto unspoken words can be discovered, uttered, and received, is fundamental to healing the isolation of trauma—especially if other people in our lives have ignored or silenced us. Communicating fully is the opposite of being traumatized.

Men and women have different experiences of the concept of power. For men to acknowledge their powerlessness means relinquishing the illusion of power in which they have been saturated since childhood. This admission allows them to seek significant connection and mutually supportive relationships within a spiritual, therapeutic, or recovery context. On the other hand, women have been admitting powerlessness most of their lives. Our access to thrones, negotiating tables, board rooms, pulpits, and presidencies has been limited. Our position has been clear—we are inferior and our power is limited. Thus the admission of powerlessness, as defined by men, has not been woman affirming. A woman-affirming recovery encourages us to reclaim our original power. Women redefine power as the capacity to author their own lives, act on their own behalf, handle whatever confronts them, and gather the resources necessary to heal into the present. These capacities are fostered in community. For men, the admission of powerlessness was essential to experience connection with others. For many women, walking into their first therapy appointment, women’s support group, or recovery meeting is a powerful act on their own behalf. The journey home begins with the courageous vulnerability of acknowledging that we have lost our way and need guidance to find our way home. A woman-affirming recovery affirms that vulnerability and power are partners on our journey home.

Exercise as Medicine More than 1000 trials have examined the relationship between exercise and depression, and most have demonstrated an inverse relationship between them.13,14 Physical activity may also prevent the initial onset of depression.15,16 Regularly performed exercise is as effective an antidepressant as psychotherapy or pharmaceutical approaches.13,17–21 Well-designed studies also support that exercise combined with pharmacologic treatment is superior to either alone, but exercise appears to be superior in maintaining therapeutic benefit and preventing recurrence of depression.22–26 Evidence provides some support for the use of exercise. A recent Cochrane review (updated from 2009) included 32 studies (n=1858) involving exercise for the treatment of researcher-defined depression. From these studies, 28 randomized controlled trials (RCTs) (n=1101) were included in a meta-analysis revealing a moderate to large effect in favor of exercise over standard treatment or control. However, only four trials (n=326) with adequate allocation concealment, blinding, and ITT analysis were found, resulting in a more modest effect size in favor of exercise. Pooled data from seven trials (n=373) with long-term follow-up data also found a small clinical effect in favor of exercise.28 The additional benefits that may be attained by patients who exercise, including increased self-esteem, increased level of fitness, and reduced risk of relapse, make exercise an ideal intervention for patients suffering from depression. Both aerobic and anaerobic activities are effective.19,23,33,34 Regardless of the type of exercise, the total energy expenditure appears more important than the number of times a week a person exercises, and high-energy exercises are superior to low-energy exercises.

That someone else can be affected by what one says lends substance and reality to one’s feelings. It confers, however briefly, a sense of self and of identity. It makes one feel recognised. It opens the possibility of being understood. It is host to reciprocation.

One does not need to create some powerful therapeutic intervention in the life of a CoA in order to make a big difference. An open door, a couch to curl up on, an after-school snack, or a place to play can make the essential difference for CoAs: they just need a place to go that isn’t in a state of chaos, somewhere where they feel they can relax.

In tense situations like this, the traditional negotiating advice is to keep a poker face. Don’t get emotional. Until recently, most academics and researchers completely ignored the role of emotion in negotiation. Emotions were just an obstacle to a good outcome, they said. “Separate the people from the problem” was the common refrain. But think about that: How can you separate people from the problem when their emotions are the problem? Especially when they are scared people with guns. Emotions are one of the main things that derail communication. Once people get upset at one another, rational thinking goes out the window. That’s why, instead of denying or ignoring emotions, good negotiators identify and influence them. They are able to precisely label emotions, those of others and especially their own. And once they label the emotions they talk about them without getting wound up. For them, emotion is a tool. Emotions aren’t the obstacles, they are the means. The relationship between an emotionally intelligent negotiator and their counterpart is essentially therapeutic. It duplicates that of a psychotherapist with a patient. The psychotherapist pokes and prods to understand his patient’s problems, and then turns the responses back onto the patient to get him to go deeper and change his behavior. That’s exactly what good negotiators do.

Jung was wholehearted in his view that the analyst’s personality is central to the success of an analysis: “Every psychotherapist not only has his own method—he himself is that method . . . the great healing factor in psychotherapy is the doctor’s personality.” He also stressed the equality of the analytic relationship, “in which the doctor, as a person, participates just as much as the patient. . . . We could say without too much exaggeration that a good half of every treatment that probes at all deeply consists in the doctor examining himself, for only what he can put right in himself can he hope to put right in the patient.