Psychotherapy
What makes psychotherapy work?
Treatment by conversation between a therapist and a patient, and the arguments about what in it actually does the work.
FilterEveryone, all time
- SA
Scott Alexander quoted
Their wordsIf you suffer from amygdala hyperactivity that gives you one of the aforementioned psychiatric disorders, I think that not only should you be offered elective amygdalectomy, but your health insurance should be glad to pay for it (especially if done via ultramodern very safe radiosurgery) one time, rather than for a lifetime supply of more expensive, less effective talk therapies and medications.
↗Absurd Adventure And Amygdalectomy Advocacyastralcodexten.com
- 8 days earlier
- AS
Arielle Schwartz quoted
Their wordsIt may not be stored there, but what you're tapping into, it's not a repository of the memory, but it's part of this mind-body feedback loop where there's a sensation that your brain has an association to that might have a familiarity to a time in which you felt sad or scared.
↗If the Body Doesn't Keep the Score, What Does?drarielleschwartz.com
- 4 weeks earlier
- JS
Jonathan Shedler quoted
Their wordsWhen patients don't get the help they need, they don't come away thinking, I didn't get good treatment. They come away thinking, I am too broken to be helped. They leave more hopeless and demoralized than when they came. That is harm.
↗When Compromised Care Becomes "Best Practice"jonathanshedler.substack.com
- 3 weeks earlier
- AA
Awais Aftab quoted
Their wordsThe emotional and relational dynamics are not an intrusion upon the work of prescribing. They are a part of the work itself.
↗The Fantasy of Being "Just" a Psychiatric Prescriberpsychiatrymargins.com
- 13 days earlier
- JS
Jonathan Shedler quoted
Their wordsThe phrase "your feelings are valid" does not invite curiosity or deeper self-understanding, which is the point of psychotherapy. It is the mirror image of "stop whining and get a grip." One sounds warm and one sounds harsh, but neither deepens self-awareness.
↗Skilled Therapists Don't Say "Your Feelings Are Valid"jonathanshedler.substack.com
- 21 months earlier
- SM
Scott D. Miller quoted
Their wordsIf one really wanted to know whether a treatment (e.g., CBT, IPT, ACT, EMDR) was more effective, it had to be directly compared to an approach intended to help - what Wampold and colleagues termed, a "bona fide" treatment. Doing otherwise, they argued, conflated artifacts of research design with actual research results.
↗Results from the first bona fide study of deliberate practicewritings.scottdmiller.com
- 3 weeks earlier
- SM
Scott D. Miller quoted
Their wordsSince 2012 when the first study appeared in the literature, others have been published documenting the tendency of practitioners to overestimate their effectiveness - on average, by 65% (1, 2).
↗Alas, it seems everyone comes from Lake Wobegonwritings.scottdmiller.com
- 7 weeks earlier
- SM
Scott D. Miller quoted
Their wordsOver the last 50 years, treatment methods have proliferated despite a lack of evidence of differential effectiveness between approaches. And even when a randomized controlled trial indicates a particular approach works, none show practitioners become more effective when they are trained in that modality.
↗How to (and not to) become a more effective therapistwritings.scottdmiller.com
- SM
Scott D. Miller quoted
Their wordsIt turns out that therapists who perform well on the FIS establish stronger relationships and are more effective (2). More to the point, the evidence shows FIS-related skills are trainable and that such training leads to better results (3, 4, 5).
↗How to (and not to) become a more effective therapistwritings.scottdmiller.com
- 6 weeks earlier
- SM
Scott D. Miller quoted
Their wordsIndeed, as I've reported in previous posts, research not only shows therapists do not improve with time and experience in the field, but on average become less effective (1, 2, 3, 4).
↗What therapist experience, a nickel, and cup of coffee have in commonwritings.scottdmiller.com
- SM
Scott D. Miller quoted
Their wordsIt's time for the field to stop attributing benefits to clinical experience. Beyond the obvious ethical concerns, doing so actually prevents us from improving our effectiveness!
↗What therapist experience, a nickel, and cup of coffee have in commonwritings.scottdmiller.com
- 9 months earlier
- TR
Terry Real quoted
Their wordsIn my practice, I have seen that opening neural pathways can lead to profound change, to brand-new traits and behavior, sometimes in a matter of minutes.
- TR
Terry Real quoted
Their wordsNeurobiologists tell us that it takes two things to unlock and open up a neural pathway. The first is that the implicit must be made explicit. Sometimes you need help seeing what you don't see. But you must be open to the feedback. Second, there must be some sort of recoil, a sense of discrepancy, of "Oh no, I'm not sure I really want to keep doing that."
- 14 months earlier
- SA
Scott Alexander quoted
Their wordsI would recommend that anyone who thinks they're suffering from trauma (eg PTSD) try a trauma-focused therapy like EMDR before trying to address nightmares directly, unless the nightmares are overwhelmingly worse than all their other trauma symptoms.
- 16 months earlier
- SA
Scott Alexander quoted
Their wordsFirst, it justifies various psychotherapies - EMDR and coherence therapy seem to come out especially well here - that focus on trying to get the brain to pay unusually precise attention, under unusually safe conditions, to something it usually represses.
- 7 months earlier
- WB
Wendy Behary quoted
Their wordsIn 30+ years of working with narcissistic men mostly - yes, it is possible for people to change. And even narcissists can change. Now, I don't really believe anyone changes completely, but it is possible to get meaningful change.
- WB
Wendy Behary quoted
Their wordsthe approach that I use is called Schema Therapy, and Schema Therapy is designed to work with very complex personality types, personality disorders, and even those that are happening along a spectrum
- WB
Wendy Behary quoted
Our readingNobody living with a narcissist should feel obliged to become their therapist.
Their wordsAnd no one should feel burdened to become the therapist of the narcissist in their life. It's not your responsibility as a partner, as a child of a narcissist, or even a friend.
- 3 years earlier
- JS
Jonathan Shedler quoted
Their wordsThe American Psychological Association (APA) just issued guidelines for treating trauma. Patients and therapists would be wise to ignore them.
- JS
Jonathan Shedler quoted
Their wordsIt takes more than 20 sessions, or about six months of weekly therapy, before 50 percent of patients show meaningful improvement. It takes more than 40 sessions for 75 percent of patients to show meaningful improvement.
- 4 years earlier
- JS
Jonathan Shedler quoted
Their wordsThe term "evidence-based therapy" is also, de facto, a code word for "not psychodynamic."
↗Evidence-Based Therapy: Science or Marketing?psychologytoday.com
- JS
Jonathan Shedler quoted
Their wordsNo research ever suggested that manualized CBT was more effective than psychodynamic therapy. It was just more often researched. There is a world of difference between saying a treatment is less often researched and saying it has been scientifically discredited.
↗Evidence-Based Therapy: Science or Marketing?psychologytoday.com