Tips from Ellyn Bader and Peter Pearson

Highly distressed couples seek out help for immediate solutions for their pain and suffering. Why is tackling the issues head-on a big mistake for a therapist?

Learn from noted couples therapists Ellyn Bader and Peter Pearson on how couples in therapy have deeply complex, embedded issues that need to be approached thoughtfully. Watch the video clip below:

This clip is from our streaming-video webcast series, “Who’s Afraid of Couples Therapy?” Join us for thought-provoking conversations with noted couples experts and explore the challenges of couples work and how you can be more effective in the consulting room.

Ellyn Bader, Ph.D., and Peter Pearson, Ph.D., couples therapists for more than 25 years, are the founders and directors of The Couples Institute and creators of the Developmental Model of Couples Therapy. They’re the authors of In Quest of the Mythical Mate: A Developmental Approach to Diagnosis and Treatment in Couples Therapy.

Who's Afraid of Couples Therapy
Starts Tuesday, July 17th
Click here for full course details.

Learning from Master Therapists How to Resolve the Toughest Clinical Dilemmas

Recently, I read a paper by psychiatrist and pioneering trauma researcher Judith Herman in which she makes the case that, rather than a scientific or technical procedure, psychotherapy is primarily a craft. Crafts, she wrote, “are strongly embedded in the practicalities of daily life, and as such are constantly subject to empirical (though unsystematic) tests of utility. They preserve a highly complex body of knowledge and skill, resisting reductive standardization. They are taught relationally, through a long apprenticeship which fosters discipline, high standards for performance, and an ethic of care. Within their disciplined forms, crafts permit wide scope for individual imagination and creativity.”

Not long afterward, I saw a movie, that exemplifies as no other film I can remember what Herman was writing about—though the subject wasn’t a therapist. The documentary, Jiro Dreams of Sushi, follows the life and work of Jiro, an 85-year-old Japanese Sushi Master. Considered by many to be the best sushi chef in the world, he's the proprietor of a ten-seat restaurant located in a Tokyo subway station—the first restaurant of its kind to ever be awarded a three-star Michelin review. The movie captures Jiro’s lifelong devotion to his work, his meticulous attention to detail, his unsparing self discipline, and the never-ending pursuit of what he knows he can never achieve: some sort of transcendent, other-worldly sushi-apotheosis. “Even at my age, in my work,” he says, “I haven’t reached perfection.” But like every great craftsperson, he’ll spend his life trying.

Jiro kept coming to mind as I interviewed a series of noted therapists for our upcoming webcast series, The 6 Biggest Challenges Therapists Face. All of these practitioners are, in their own way, master craftspeople, with highly evolved skills in working with particularly difficult clients and resolving clinical dilemmas. Wendy Behary describes in fascinating detail exactly how she gets through to unpleasant, often quite aggressive narcissistic clients—frequently regarded with reason as “impossible” to treat. John Norcross shows us how he changes his own therapy style to fit different kinds of clients, making the obvious—but often overlooked—point that one-size therapy certainly doesn't fit all clients. Clifton Mitchell explains to us, in a way that can be both painful and hilarious, the common mistakes therapists make that actually increase client resistance, and then gives us play-by-play suggestions for avoiding and dismantling it.

For me, the whole experience of making these webcasts has been a revelation. Sitting at my computer, not only do I get to have a late-life career as a kind of poor man’s Charlie Rose (actually more like Charlie Rose crossed with Wayne of “Wayne’s World”), but I also get to experience something like genuine personal tutorial/therapy sessions with these master practitioners. Sometimes the pretend “therapy session” feels quite a lot like the real thing. In an interview with Dick Schwartz, originator of Internal Family Systems Therapy, I got to tap into my own inner borderline while role-playing a client, and gained a felt sense of how deeply reassuring and empowering Dick’s way of working with a client’s discordant inner parts can be.

With each practitioner in this series, I felt I was truly experiencing the ways very different therapists think and work. It was like getting a close-up look at a master potter or cabinet maker slowly, painstakingly, with great concentration and prowess, turn a piece of raw shapeless clay or plain wood boards into a work of art—you’re fascinated, awed, and enlightened all at once.

The whole point of our Networker webcast series is to help therapists break out of our usual mode of operating, opening windows into the minds of gifted people who work and think much differently than we do. It’s truly rare to have such an opportunity to get such candid, immediate access to what master therapists really do in their consulting rooms. Putting aside the impressive-sounding theories and showmanship of the typical workshop presentation, these interviews offer us all a chance to realize anew just how subtle and richly varied the skills that distinguish the most accomplished practitioners of our therapeutic craft.

The 6 Most Challenging Issues in Therapy
...And How Therapists Can Overcome Them
Starts Thursday, June 21st
Click here for full course details.

Other resources you might find helpful:

Articles
Wendy Behary
The Art of Empathic Confrontation
http://www.psychotherapynetworker.org/CEcourses/audio/handouts/A914/A914_the_art_of_empathic_confrontation.pdf

Janina Fisher
Breaking Free
http://www.psychotherapynetworker.org/component/content/article/301-2011-marchapril/1263-case-study

Richard Schwartz
When Meditation Isn’t Enough
http://www.psychotherapynetworker.org/magazine/recentissues/2011-septoct/item/1518-when-meditation-isnt-enough

Videos
Wendy Behary
Treating the Narcissistic Client
http://www.psychotherapynetworker.org/blog-communities/NetExchange/viewpost/1435_Treating_the_Narcissistic_Client

John Norcross
Customizing Mental Health Treatment
http://www.psychotherapynetworker.org/blog-communities/NP0021/viewpost/1431_Customizing_Mental_Health_Treatment

Experience Internal Family Systems Therapy with Richard Schwartz

Get a taste of what it’s like to work with clients who have Borderline Personality Disorder, and see for yourself what Internal Family Systems Therapy looks like in this clip from our upcoming streaming-video webcast series, "The 6 Most Challenging Issues in Therapy."

In this presentation, Richard Schwartz, the founder of Internal Family Systems Therapy, discusses the experience of working with clients who have Borderline Personality Disorder and how therapists can approach such clients with a sense of hopefulness and collaboration. This clip below, a role-play between Richard Schwartz and Rich Simon, illustrates a scenario between a therapist using the Internal Family Systems treatment of working with inner “parts” and a client who’s never worked in this way before.

Richard Schwartz, Ph.D., is director of the Center for Self Leadership and the originator of the Internal Family Systems model. His books include Internal Family Systems Therapy and, most recently, You Are the One You’ve Been Waiting For.

The 6 Most Challenging Issues in Therapy
...And How Therapists Can Overcome Them
Starts Thursday, June 21st
Click here for full course details.

How to Handle the Issue of Progress Before it Becomes a Therapy Crisis

Don’t wait till you get bored. Don’t wait till drastic action seems to be the only option. Act as soon as you sense that a client’s progress is leveling off or slipping backwards.

See how Bill Doherty’s simple, proactive approach can lead to positive developments when a therapy starts to stall.

This clip on how to put the topic of progress on the agenda in a session is from our upcoming streaming-video webcast series, "The 6 Most Challenging Issues in Therapy ...And How Therapists can Overcome Them."

Another resource that you might find helpful in dealing with challenging cases is his article on "Treating the Mixed-Agenda Couple."

William Doherty, Ph.D., is a professor and director of the Citizen Professional Center at the University of Minnesota. He's the author or coauthor of 12 books on families and family therapy, including Take Back Your Marriage, Take Back Your Kids, and Family Therapy, with Susan McDaniel.

The 6 Most Challenging Issues in Therapy
...And How Therapists Can Overcome Them
Starts Thursday, June 21st
Click here for full course details.

How and When to Discuss Sexuality with Male Clients

Explore the myths and realities of male sexuality with Esther Perel and better understand practical tools for effectively helping men with relational and sexual issues. In this clip from our streaming-video webcast series, "Men in Therapy: What Clinicians Need to Know," she discusses how to bring up sexuality when working with male clients, when she feels it’s important to discuss it as part of therapy, and shares some examples of questions she might ask men in session.

Esther Perel, M.A., L.M.F.T., is a master trainer, therapist workshop leader and speaker and an acknowledged international authority on couples, culture and sexuality. The author of the international bestseller Mating in Captivity: Unlocking Erotic Intelligence she's an AASECT approved sex therapist practicing in New York where she's on the faculty at Columbia University and at the Ackerman Institute. She’s the recipient of the 2009 book award from the Society for Sex Therapy and Research.

Engaging Men In Therapy:
Everything Clinicians Need to Know
Starts Tuesday, June 5th
Click here for full course details.

How We Can Solve Our Most Challenging Cases

The desire to keep growing and improve our skills is a good part of what brought many of us into this demanding profession.  But once we’ve acquired some experience and achieved a certain level of competence, we may begin to fall into a routine, just repeating ourselves over and over again. After all, getting to the next level—transcending our own current performance—often requires us to leave our normal comfort zone, not something many of us relish doing. Nevertheless, getting to that next level of mastery doesn’t just improve our performance—it can make us feel renewed as human beings.

Let me give you an example from my after-hours life as a pick-up basketball player.  I’ve been playing basketball for close to 50 years now—thousands of hours dribbling, running up and down basketball courts, working on my jump shot, pushing and shoving complete strangers. For a 63 year-old considerably beyond the usual age for a viable basketball career, I’m not a bad player. But over the last few years, I noticed that I was just repeating my old tricks, doing the same things I know how to do, over and over again. I still loved basketball, but there was getting to be a certain sameness about my game. I felt stale.

Last year at this time, I got inspired watching the Dallas Mavericks, one of the oldest teams in the NBA with a roster of geriatric 30-somethings, win the league championship. I was drawn to try for my own basketball breakthrough and see if I could get out of my benign rut.  I found myself a coach—a 25-year-old named Andrew who loved basketball even more than I do and seemed to have studied everything there is to know about the game. Since then, he’s become my basketball guru and taskmaster. Every week, I have a session with Andrew, who keeps pushing me to expand my game, after which I take notes and practice what I’ve learned. Andrew’s very nice, but very tough. Instead of telling me how great I am at stuff I already know how to do well, he relentlessly points out the limits of my game, and then shows me how I can improve.

A few weeks ago, for example, after observing how predictable my offensive repertoire was, he announced, “You always drive right, never left. You gotta expand your game.”  As a right-handed person, I naturally tend to dribble with my right hand, make jump shots to my right, pass to my right, and so on. So he started pushing me to focus on dribbling with my left hand, driving to my left, and hitting left-hand lay-ups. It felt unnatural, awkward, hard to do, but I practiced the moves he showed me again and again and again. One day, after a couple of weeks of this, I found myself playing one-on-one with a familiar rival who had the annoying habit of beating me. I was determined that, regardless of how awkward it felt, I’d make myself drive left. Quite familiar with my right-wing basketball tendencies, my opponent kept overplaying me to move to my right. Instead, I kept hitting left-handed lay-up after lay-up and won easily. But not only did I feel the fleeting joy of victory, I had that incomparable sense of suddenly discovering a new self, not bounded by my old limitations. It was thrilling.

As therapists, we all face situations and cases that tap into our particular limitations, make us feel frustrated and incompetent. We all tend to get into our ruts, avoid certain kinds of clients, or feel off-balance and uncomfortable in the face of clinical challenges that press our particular buttons. And in a sense, the presenters in our upcoming webcast series The 6 Biggest Challenges Therapists Face are like Andrew. They recognize what keeps us limited in our effectiveness and how routinized our practices can become. But, like Andrew, they have highly practical suggestions—offered in the context of very vivid case examples—for helping us get beyond our limitations.

Without Andrew, I’d still be avoiding what I didn’t feel fully competent doing. But he’s opened up a whole new range of choices for me on the basketball court. I hope you discover some new choices for yourself in our new webcast series and up the level of skill and excitement of your “game” in your consulting room. 

How to Maintain Compassion While Achieving Leverage

Discover how to effectively treat narcissistic clients with Wendy Behary by learning how to use tactical confrontation, cognitive restructuring, behavioral therapy and skills training, experiential psychotherapy, and more. In this clip from our upcoming streaming-video webcast series, "The 6 Most Challenging Issues in Therapy ...And How Therapists Can Overcome Them," she describes what it’s like to work with a typical narcissistic client in the first session, and the process she undergoes to successfully relate to these kinds of clients.

Wendy Behary, L.C.S.W., the founder and director of The Cognitive Therapy Center of New Jersey and of The New Jersey Institute for Schema Therapy, is the author of Disarming the Narcissist: Surviving and Thriving with the Self-Absorbed.

The 6 Most Challenging Issues in Therapy
...And How Therapists Can Overcome Them
Starts Thursday, June 21st
Click here for full course details.

Becoming a Smarter Therapist

Once we’re past the early stages of our training, the accumulating evidence suggests that, despite our own favorable impression of our increasing therapeutic savvy, most of us don’t improve our clinical skills. With so many smart, devoted, hard-working practitioners in the field, how could this be? In “Is Psychotherapy Getting Better?” a provocative article by Diane Cole in the March issue of the Networker, Bill Doherty observed:

Dear Colleagues,

In celebration of the Networker’s 30th anniversary, we’ve been taking some time to reflect on the past three decades: what have we been doing as a magazine? As a community? As a field? Where are we going?

Back in January, we asked subscribers to contribute their personal stories about how the magazine has influenced their development as therapists and as people. We wanted to know if there were any specific issues or articles that had a significant impact, led to an interesting experience, or really, anything that readers wanted us to know.

We were so honored by the responses that came pouring in, and would like to post some of these responses (many in an abridged format) here. We’d love to hear more, too. If you’re a subscriber of the magazine, we’d love to provide you with another opportunity for response and comments here.

If you’re not a magazine subscriber but still a part of the Networker community—a webcast participant, a Symposium attendee, or just a fan in general—we want to hear from you, too. How has the Networker community impacted you? And an even larger question, if you’ve gotten a chance to read our March/April issue on “Is Therapy Getting Better?”—what do you think? Where do you think this community, and the wider community of mental health professionals, is headed?

-Rich Simon

Read more

I just have to say “wow.” What an incredible session. I always love hearing Mary Jo present because she’s such an incredibly clear speaker and seems so down-to-earth. I have this overriding feeling of trust in her—she knows what she’s doing, based on both her experience and research, and although she’s confident in her work, she’s organized and meticulous about staying in the moment and being deliberate.

Read more

It turns out that we’re not the only ones talking about MIT psychologist Sherry Turkle, our Symposium keynote speaker. Her new book, Alone Together, an insightful look at our shifting relationship with technology, has gotten a lot of press recently, earning glowing reviews from both Newsweek and Time.

Have you ever text messaged someone who’s in the same room or e-mailed people in your office rather talking face-to-face? While our beloved new gadgets make our lives more efficient—and entertaining—are they actually separating us, instead of connecting us? Turkle says they are. This week, she appeared on the Colbert Report to discuss it.

“It’s that time of the year again,” writes Judith Matz in her cover piece on our national obsession with dieting in the January/February Networker. “Every January, the weight-loss frenzy begins anew as the overeating of the holiday season subsides and millions of us resolve that this will be the year that we will lose weight and keep it off.”

Our national cornucopia spilleth over our waistlines in rolls of fat even more than it did 13 years ago: obesity rates were 15 to 20 percent in 1995, and about 34 percent in 2008. The Centers for Disease Control and Prevention tells us we’ve become an “obesogenic” society, “characterized by environments that promote increased food intake, nonhealthful foods, and physical inactivity.” For more information, click here. Read more

Last September, the Networker published an issue called “Life After 2.0,” devoted to exploring whether we’ve crossed a threshold in our relationship to technology--even therapists like me, a committed technophobe. As we explored the social and clinical impact of the ever-more-advanced communication technologies, I got more and more curious about what I was missing out on. Finally, I took the plunge and bought an iPod, and my life hasn’t been the same since. Read more

Remember when setting appropriate boundaries in psychotherapy was a no-brainer? “No” was the operative word--no gifts, no sex, no self-disclosure, no financial or social connection whatsoever outside the hermetically-sealed cloister of the consulting room. The rules were simple, direct, and unambiguous. But in today’s more informal therapy marketplace, the rules often don’t seem as clear anymore.

So what’s a therapist to do when a client anxiously offers a diamond-studded token of appreciation for all of the positive change you’ve helped him achieve? Do you accept a not-so-valuable gift--a tin of holiday cookies--from a vulnerable client to express thanks? What’s your decision when your therapeutic instincts conflict with the rulebook?

I highly recommend one article in particular--Ofer Zur’s “The Ethical Eye” is a refreshingly sane and practical discussion of how to reconcile risk management with humanistic values. You can read this article free or you can read it as part of our 3-CE Ethics Reading Course.

How does today’s culture make ethics more (or less) complicated in your practice? What resources do you consult in order to make the best possible therapeutic decisions?

Does communications technology--Skype, e-mailing, text messaging, Facebook, or even the telephone--pose any ethical issues to our therapeutic practice? Which modern ethical dilemmas would you like to hear more about--or are there any of your own that you’d be willing to share?

Rich Simon
Editor, Psychotherapy Networker

An article in the December Archives of General Psychiatry just reported that only 43 percent of people who sought treatment for depression went to a psychotherapist. This is part of a larger trend over the past couple of decades that has seen the number of people referred for therapy by physicians drop nearly 50 percent.  Read more

Thank you to everyone who attended today’s webinar, Bill O’Hanlon’s “The Web Made Easy.” This session--and this Comment Board!--is an integral part of the collective learning process we’re all embarking on together, in order to understand the changing world around us.

Please take a minute to tell us about what stood out for you during today’s session--a piece of useful information or a thought-provoking anecdote. Or, share with us your favorite technological tools that have benefited your professional or personal life. What are some resources you use to improve your practice or yourself?

Please share with us whatever you felt was most striking about today’s webinar and, to create a better sense of community, we invite you to include your name and hometown with your comment. Thank you all so much for your participation and inspiring thoughts.

Wow… after reflecting on yesterday’s second session of Dan Siegel’s Master Class, I realize that that feeling of amazement comes from the idea that we really are “dancing” with our brains through this particular course. It’s taken me a little while to process all that I learned in his one-hour webinar (which never really seems to be long enough for a conversation with Dan!) because I found so many aspects of his talk so intriguing.

Like Rich Simon said during today’s first Master Class webinar session with Dan Siegel, it’s absolutely amazing what opportunities technology affords us all. This kind of experience is extremely relevant to the kinds of online applications mentioned in the current issue’s articles.

Well, it’s arrived: the September/October issue is online! I think that this is a really special issue--truly, this topic of how our human relationships are affected by our digital ones is extremely relevant. Read more

I think there’s just something universally difficult about coming back to everyday life after a long holiday weekend like Labor Day. Sometimes it’s because having that extra day to sleep in throws you off schedule, and sometimes it’s because that long weekend was actually spent accomplishing more on your ever-growing to-do list. In any case, most people seem to feel that their week afterward--even if the week is only four days!--is unusually tiresome.