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P004, Attachment, Session 4, David Schnarch

 

This session will air on Tuesday, April 26th 2011.

Join David Schnarch, a leading proponent of the role of differentiation in the therapeutic process, as he discusses his perspectives on attachment and why he believes that Attachment Theory can keep clients in the role of needy children.

This fourth session of “The Great Attachment Debate,” will go over the importance of differentiation in healthy development, delve into enmeshment and how it contributes to fused relationships, explain “attachment hegemony” and how it can get in the way of effective therapy, and much more.

After listening to Schnarch’s presentation, we encourage you to please reflect on what you’ve learned and comment on what was most interesting to you, ask any questions you may have, and share any relevant experiences. We invite you to include your name and hometown, and to review what other participants have to say about this particular session and their webinar experiences.


04.22.2011   Posted In: P004 New Perspectives on Practice: The Great Attachment Debate   By Psychotherapy Networker
70
Comments
 

  • Not available avatar 45227BURIKJW04 04.26.2011 13:12
    In fairness I acknowledge that I am *not* a couples therapist. That said, what struck me on the gut level is Schnarch comes off as a jerk. My thoughts, as I regained some level of objectivity, is that he has virtually no understanding of (a) attachment or (b) interpersonal neurobiology. I see *some* value in his approach as a type of provocative therapy -- which may be of value to a particular set of clients -- but my sense is empirical results of his work will be similar to what I see in Foa's work: outcomes look good because of the "treatment failures" who self-select out of the treatment (experimental mortality).
    Reply
    • 0 avatar Steve Nasuta 04.26.2011 13:15
      Ditto to previous comment. Also would question the other aspect of self-selecting client outcomes, in that Schnarch's description of his treatment protocol includes several-hour sessions over several days, on a self-pay basis (not that any insurance in my experience would pay for such a gluttonous model anyway). So how many couples are able to be seen in a given work week? And at what rate of reimbursement? And what is the socioeconomic profile of couples who undertake this therapy?
      Reply
      • Not available avatar David Schnarch 05.01.2011 14:12
        Hi Steve,
        Don’t confuse how I myself do therapy now with how the approach is done (treatment protocol) or how it was developed.
        I do in fact do several-hour sessions over several days because this way people can fly in from across the country and around the world for therapy. But I originally developed the approach doing conventional 1-hour weekly or bi-weekly sessions, and this is what we teach our students to do. You ask, “So how many couples are able to be seen in a given work week?” In New Orleans, before relocating to Colorado, I saw clients locally for 1 to 2 hours every two to four weeks, and I had a completely full 5-day a week practice. You can do the math.
        When done in this conventional format, insurance companies are no less likely to reimburse this approach than any other. However, one reason therapists enjoy my approach is they become known for handling difficult cases and no longer have to take insurance if they prefer not to. Having a therapy good enough that people are willing to self-pay is a win all around. This doesn’t lock out poor people out of our approach. There’s nothing in the approach that says you can’t take insurance, and if you don’t you can still use sliding scale basis.
        “A gluttonous model”? Far from it. People say this is the best value for their therapy dollar they’ve ever had.
        Reply
      • Not available avatar Charles Green 01.19.2014 09:55
        Just running across this now-several-year dialogue now.
        A jerk? More like a bit self-involved, cutesy, involved with himself.
        But to all the rest – you're nuts. He's the best therapist I ever saw. He's real, intelligent, fearless, on-the-spot smart.
        I only attended one of his sessions (does that make me an opt-out?) but it has stayed with me the rest of my life.

        Keep working on regaining your objectivity, I think you've got a ways to go.

        As to whether he knows anything about "interpersonal neurobiology," I cannot say; but I can say my own experience with the so-called sciences that preface their names with "neuro-" is that they mistake description for insight. Describing things in chemical terms adds virtually nothing to human insight. Schnarch's continually provocative insights send off more sparks in a minute than a semester's worth of the other stuff.

        Interesting you put "provocative therapy" in quotes. As a layman, I have to ask, what other good kind is there? What I've seen of most therapy is that what few insights are presented are so wrapped in layers of sugar masquerading as empathy that the client leaves thinking they've been justified in thinking their same old beliefs. That's not valuable.

        For what it's worth, in the 2-day session I spent with Schnarch, about 25 couples started the session. And 25 finished it. To great applause. So much for self-selection out, at least in my experience.

        Having actually seen Schnarch in action, I have to say, you truly don't get it.
        Reply
    • Not available avatar Roger Lake 04.30.2011 19:32
      I can see how you can think that David is a jerk. Particularly if you don't work with couples. I know and like David, and, as he completely acknowledges, he can be self-centered. He is also an excellent therapist who does have challenging ideas.
      If you don't work with couples, how do you understand cruelty in the here and now? Get some training with couples. You'll begin to understand the multi-dimensional mind maps that characterize the first encounter.
      I'm not David's student, so I don't know how teachable his system is. As a colleague, he presents interesting ideas and he does know whereof he speaks. He also certainly has self-selected clients, and he is way better at marketing than anybody else I can think of including Sue Johnson.
      I think Rich might have done a little more to reign him in during the interview and focus on the ways he mind-mapped the couple, quieted the system through naming it, and organized a collaborative relationship that the couple was falsely presenting, into one that served the interest of intimate and real communication.
      Nobody is likely to fly in for four days at elaborate expense to show up in my office, but the IDEAS that David is talking about are the really important issue in understanding how attachment functions in the consulting room to reorganize communication, intention, individual accountability and the functional agreements that the couple makes.
      David may not be your cup of tea, but he's a very important voice in this conversation.
      Reply
      • Not available avatar John Burik 04.30.2011 20:38
        Hello Roger, big point of clarification is I didn't say he "is" a jerk but "comes off as a jerk." I also guess you're not really suggesting that only couples therapists "understand cruelty in the here and now."

        I personally did not find this webinar to be much of a conversation or debate, say, in contrast to the Kagan offering.
        Reply
      • Not available avatar David Schnarch 05.01.2011 14:06
        Dear Roger,
        Thank you for your thoughtful articulate reply to 45227BURIKJWO4. I appreciate you articulating what you find useful in my efforts, while maintaining your own independent view. I comment in a post below about training issues, so I won’t mention it here.
        More importantly, your post gives me the chance to clear up something that’s bothered me ever since Rich and I taped our session. A bit of unintended jerkiness I need to clean up, that also allows me to respond to your request for more information about the case
        In the course of our discussion, I started talking about a wonderful couple I’d just seen and was much impressed by, to illustrate how there are many people for whom attachment-based therapy works poorly and slowly, who make rapid dramatic progress in differentiation-based therapy. The wife being an attachment-based therapist particularly highlighted this point.
        I was getting too involved in the case, and Rich exercised his responsibility and prerogative and had me move on. In retrospect I been concerned because I never got to the big part of the story: about how both partners “stood up” in incredible acts of integrity and partnership, and “took the hit” (tolerated pain for growth) on astonishing things. How astonishing? The husband had a pattern of neurobiological impairments I’ve only seen now three times in 30 years of practice, involving things he never talked to anyone about for 45 years. On the fourth day of the Intensive, he’s whole picture of his life turned around in three and half hours of painstaking methodical grueling therapy.
        This never would have happened without the wife trying to implant in my mind that I should treat her with kid gloves, I shouldn ‘t mess up privaledged ways she ran their relationship, and I shouldn’t expect her to do anything that made her nervous. When I said I knew she was doing this (within the first hour of therapy), and I wasn’t going along with any of them, she wasn’t happy. By an hour and a half into the first session I had enough information to tell them I was concerned they were going to fail because they were giving me an inaccurate picture of themselves and their relationship. But by the end of the first session, she let me walk her into a completely different, and far more anxiety-provoking and integrity-testing view of her issues. Both in that session, and later that evening, the “bottom fell out” for her. By the time she returned for our session on Day Two, she looked, felt, and functioned remarkably better. So much so, her husband could see the difference. This provided the motivation and foundation for the husband to walk to the chasm of his life and look down into it, forcing his brain to do what it was powerfully wired to avoid.
        I have nothing but respect for these two individuals. I know it was particularly hard for the wife. As an attachment-trained therapist, as someone who hid out in prior attachment-based couples therapy, and as someone wired to do a little heart-eating of her own, it was hard for her to make herself walk into her fears and not tamper with the truth. But when it was necessary, and quicker than many clients, the wife confronted herself. The husband, wife, and I watched the best in her stand up before she left that first day.
        Unfortunately, as Rich and I co-constructed the session, the true highlight of the story got lost. Focusing on the conversation, trying to display the appropriate slide, tracking of where I was in retelling the story, where we were in the webinar, and monitoring impressions I’m giving was simply beyond my mortal abilities.
        In retrospect, and with regret, some viewers could arrive at an inaccurate picture of how I view this couple. I watch many clients go from immature limited people to the best of what people can be. I thought this one was particularly special. Having seen the benefits first hand, this couple kindly let me share their story because it might induce more therapists to reconsider attachment-based and differentiation-based therapy. They are entitled to an accurate depiction of their efforts, and my respectful appreciation of their basic decency and courage.
        Thanks again for your thoughtful interest in my work.

        David
        Reply
    • Not available avatar David Schnarch 05.01.2011 13:38
      Dear 45227BURIKJWO4
      Why don’t we start by finding common ground on which we can agree. I have to cop to being a jerk. I have outcome data to prove it. I just celebrated my 25th wedding anniversary, and after collecting 28 years of data, Ruth says she’ll provide a notarized statement that I’m less of a jerk than I have ever been. Being a jerk doesn’t begin to describe my shortcomings.
      It’s hard not to come off looking like a jerk, when questioning attachment-based therapy boarders on blasphemy. In any event I hope you overlook my limitations or see beyond them, and apply your discernment to clinical limitations and problems within attachment-based therapy. Look for ideas and methods that make sense when seen through the attachment theory lens, but don’t line up with the ways adult relationships really function, or how the human adult self really develops.
      I take you saying I have virtually no understanding of attachment or nterpersonal neurobiology to mean I don’t see either area as you (and many other therapists) do. When clients say they don’t feel “seen,” they mean their partner sees them differently than they see themselves. When partners mirror back to us the distorted picture we have of ourselves, we feel “understood.” When they see us as we really are, we feel “misunderstood.” The same is true of us as professionals regarding our preferred theories and methodologies.
      I like your thinking that my “outcomes look good because of the “treatment failures” who self-select out of the treatment (experimental mortality.)” You demonstrate the discerning multiple-hypothesis-generation method we teach and admire, and wish more attachment-based therapists did in examining treatment practices. In this case, however, the hypothesis is wrong. If it were true, I’d expect dropout to occur in the first session(s). That rarely happens. In fact, “treatment failures” are infrequent enough I’ve been able to study them and improve the therapy. A therapist can’t do that if he or she has high “client mortality.”

      David
      Reply
  • 0 avatar Gabrielle Sarfaty 04.26.2011 13:13
    I would like to thank you David for your perspective on couple's therapy. I have been a strong believer in accountability in behavior as this creates empowerment for change in any relationship. How do you elicit commitment from the couple so that they will trust the process of facing their "dark side" in order to transform it? Thank you for your presentation.
    Reply
    • Not available avatar David Schnarch 05.01.2011 14:27
      HI Gabrielle,
      Thank you for your thanks. 45227BURIKJW04 and Steve were helping me remove any remaining dependence I have on a positive reflected sense of self from others. But it always is nice to be appreciated, no matter how differentiated anyone gets.
      I completely agree that accountability empowers change. You ask how I elicit commitment from couples so they trust the process of facing their "dark side" in order to transform it. I love your question because it highlights important differences between an approach based on attachment security and feeling safe, vs. an approach rooted in differentiation. First off, I don’t elicit commitment from couples as a precursor to them facing their “dark side.” One of the key issues is their refusal to do this until now. Ask for or extracting a verbal commitment is naïve. When they face their “dark side,” that is making the commitment.
      Second, they have no reason to trust the process of facing their “dark side” until therapy is over. Most people don’t believe they would be truly loved if they were truly known—and the point is to get over this. Safety-and-security-based therapy gratifies people’s fantasies that they have a right to be sure of the outcome before they are expected to make a move. This can only be “guaranteed” in a collusive treatment alliance, and therapists’ attempts to reduce the inherent anxiety in true self-confrontation limit the differentiation benefits to the client.
      Part of the way I help clients mobilize themselves to confront their limitations is by keeping these two points omnipresent in my mind, and explicit in my interactions with them. But another big part is I talk to the best in people. There is a part in many people that wants a crazy-making deal--where we insist on our partner’s acceptance before the fact, and then know he or she can’t be trusted because they just signed a blind contract. This is not the best in people. The best in us knows right from wrong, knows when we are buying our own BS, and being scared, insecure, or upset doesn’t change things.
      Taking to the best in people is not easy in any case. I believe attachment-based therapy is particularly prone to making therapists think they’re talking to the best in people when they are not. The Crucible Approach has developed a theorem that helps clients and therapists stay on track, and earns credibility with people who trust no one: Only the best in us talks about the worst in us, because the worst in us lies about its own existence.
      So to summarize my answer to your question, I use collaborative confrontation to walk the best in people into their personal limitations and limited development. Their integrity is the backstop that keeps them from running away. There is no “safety net,” and I neither can nor feel obliged to offer one. A great metaphor exists in Indiana Jones and the Search for the Holy Grail, when Jones’ choice is to walk out into thin air “trusting” there’s an invisible bridge that goes across a bottomless canyon or let his father die. Only in families, it’s let your children die or be emotionally harmed, or let your marriage and family fall apart. Jones doesn’t “step out” because he trusts there’s an invisibly bridge. He steps out while he’s convinced he’s going to die, because of his love for his father and his desire to maintain his own integrity. People don’t confront their “dark side” when they think they can handle this. People do it when they’re more afraid of what happens if they don’t. Trying to turn this into something “safe” denatures and limits the differentiation benefits to the client.
      Reply
      • 0 avatar Betsy Amey 05.11.2011 12:16
        Thank you, David, for clarifying what was so exciting to learn from you years back. It is difficult, but so necessary, to have faith in the individual's ability to tolerate the anxiety, not depend on us to create the "safety."
        In working recently with people who carry the stigma of BPD, I hope I have learned that promising positive outcomes based on what the therapist is going to do or know is a great way to cause disasters. Thank you for reminding us that "collaboration" must be "confrontational," at least half of the time. That is respectful of the client and the pain he/she has experienced, I think.
        Reply
  • 0 avatar Merrilee Gibson 04.26.2011 13:19
    What an exciting and challenging presentation! What I liked most was the idea of “civilized debate." In these past weeks we have been been hearing some intense and valuable ideas that are in many not ways in agreement. But they all have merit, deserve more thought and understanding. I hope for civilized debate, something I fear I our society in general, and the world of psychotherapy perhaps in particular, has nearly forgotten how to engage in.
    Merrilee Gibson
    Reply
    • Not available avatar David Schnarch 05.01.2011 14:37
      Thanks for the kind words, Marlee.
      I love hearing someone go beyond what Alan German calls “garbage can eclecticism” and see that many ideas floating around the industry today don’t really fit together. I recently chatted with a senior German clinician who said psychoanalysis and behavior modification were not that difficult to reconcile. I asked, “When you get down into the bowels of these two approaches, do the fundamental assumptions really line up?” A moment later she smiled, “Not really.” This is why I love training European therapists.
      Remember, to me the issue is not attachment theory, it is attachment based therapy. Attachment-based therapy and its offshoots are so widely acculturated in the American therapy industry, it seems heretical to question many of its basic assumptions, in part, because those assumptions now strongly shape many therapists’ methods. If these methods don’t produce powerful therapy, regardless of how it aligns with attachment theory, that’s a problem in the industry and a social health problem for society. This problem extends down to how society spends its therapy dollars, and therapists need to take this seriously.

      David
      Reply
      • 0 avatar Merrilee Gibson 05.01.2011 17:11
        Dr. Schnarch,
        How very caring and thoughtful you are to provide each of us with comments. I was just reading the comment board, and there is so much material it’s like another webinar session, and very thought-provoking. I think you must be a teacher at heart. Thank you so very much for sharing.
        Merrilee Gibson, San Mateo, CA
        Reply
        • Not available avatar David Schnarch 05.01.2011 18:30
          Dear Merrilee,

          You touch my heart and make it all worthwhile. I can't promise to keep this up.

          My humble thanks to you and all the others (including Rich Simon) for providing the basis for an absolutely essential dialogue.

          I'll be interested in your reactions when you've had time to digest my responses. One way to look at them is through the same eye for consistency or inconsistency you approached different webinars:

          Are the things I'm saying internally consistent. Do the ideas REALLY fit together? Isomorphic intervention is not yet standard practice in psychotherapy. Inconsistencies in the treatment paradigm potentiate non-isomorphic interventions in treatment. When you get done scrutinizing my approach, turn your eagle-eye to attachment-based therapy.

          Have a good time. The field needs you. Mediocre therapists can find similarities between approaches and ideas. Our field needs people who see how things DON"T fit together. We need you to help take psychotherapy to the next level. And we need you because that's the way therapy needs to be done. In a collaborative therapeutic alliance, the therapist listens for how things DON"T fit together. It's not an adversarial stance, it's the therapist's job.

          Kind regards,

          David
          Reply
          • 0 avatar Merrilee Gibson 05.01.2011 21:29
            Dr. Schnarch,
            Thank you again. I will certainly review all this in more depth. Right now, my “eagle eye,” as you put it, is already on attachment theory, at least in part. I am in the midst of writing my Doctoral dissertation. I am knee-deep in books by Rogers, Bowlby, Fonagy, Stern, Schore, not to mention Erikson, Piaget, Lev Vygotsky, Anna Freud, Melanie Klein, Hermine Hug-Hellmuth . . . well, you get the idea, I’m sure.

            I find your “in your face” approach so refreshing. My license title is “Marriage and Family Therapist” but in fact I think our preparation for couples work is beyond woefully inadequate. I have done some couples work, and I have found it quite a challenge to penetrate the glaze that has set in around the couple who have waited—as they all seem to do—to come to therapy until their situation is truly dire. But I work primarily with children, and I especially like to work with very young children, starting about age 3. So, while I find couples work fascinating I’m not doing any of it right now. My basic therapy approach is Rogers and, for children, Axline. My dissertation is a case study of therapy with a 3-year-old, and attachment issues do come into it.

            Well, I’ve probably lost you by now, so I’ll stop. Truly, I can see the value in the kind of challenge you offer couples. When I’m through with this current project, I will certainly take a closer look at what you are doing and saying.

            My sincerest thanks for your graciousness.
            Merrilee Gibson
            Reply
  • 0 avatar Richard Clampitt 04.26.2011 13:28
    It seems to me that the "I see you" perspective builds secure attachment which reinforces the attachment position. I don't think that attachment means the absence of differentiation, but promotes it instead. A good goal in working with couples is building attachment in the couple while promoting differentiaton that arises out of being securily attached.
    Reply
    • Not available avatar David Schnarch 05.01.2011 14:46
      Hi Richard,
      I agree attachment-based therapy says “the ‘I see you’ perspective builds secure attachment which reinforces the attachment position” is the way relationships work. Anyone familiar with attachment theory will immediately validate the logic of this thinking. But here’s what’s missing: Is this really the way adult relationships naturally operate of their own accord? If not, then you have a therapy that can improve couples’ functioning somewhat while still being contrary to how relationships work. Therapies that produce pseudo-differentiation, for example, do this all the time.
      “I see you” through the lens of differentiation looks real different—and more real. Look at all the people who are afraid to really be seen. Stop looking at their fear. Look at how they are mind-mapping pros, often masking their own minds, and tampering with the partner’s mind when he or she starts to really see them. Is this who you want to offer “attachment security?” For them, truly being seen necessarily precipitates attachment insecurity and necessarily challenges the foundation of their relationships. This is what produces more stable, intimate, passionate committed relationships. And that is how relationships naturally work.
      I like your statement, “A good goal in working with couples is building attachment in the couple while promoting differentiation that arises out of being securely attached.” I’ve heard this said many times and even read it in a journal article. It so clearly illustrates how therapists attempt to straddle a chasm they think is a crack, by blending two approaches which make diametrically opposite clinical interventions for entirely opposite purposes. In our therapist training, we call this “crossing your own lead.” I would say it this way: “A good goal in working with couples is building attachment in couples by promoting differentiation, which requires becoming less emotionally fused.”

      David
      Reply
  • 0 avatar toni herbine-blank 04.26.2011 13:29
    David,

    I am a trainer of a body of work called Internal Family System Therapy and have developed a program for the application of this model to Couples Therapy. Although I do not agree with all you have to say, I appreciate the call to a model of differentiation for couples. I appreciate your comments at the end of the seminar that it is in the diffentiation process that Couples can find their way back to open- hearted interactions (re-attachment as it were). In IFS therapy we also view the human system as whole and resilient and the Self accessible. Our approach is quite different from yours but I am resonating with the need for adults to learn to trust themselves before working on making their partners trustworthy. I think you are not as tough as you say you are. Being able to "see" people's dilemmas and create an environment where they feel it will serve them to work with you indicates you ability to resonate, empathize, acknowledge and offer hope. Interpersonal neurobiology is in itself safety creating and brain changing.
    Reply
    • Not available avatar David Schnarch 05.01.2011 14:59
      Hi Toni,
      Thank you for seeing traits in me some therapists think I’ve had surgically removed. My empathy and resonance make me willing to speak out as I have. My limitations sometimes interfere with me doing this as elegantly as I’d like.
      I appreciate all you said including, “it is in the differentiation process that couples can find their way back to open- hearted interactions (re-attachment as it were).” I absolutely agree about the move towards open-hearted interactions and their positive impact on the couple. Likewise, the need for adults to learn to trust themselves before working on making their partners trustworthy.
      But “re-attachment as it were,” is the whole point of the discussion. Taking result achieved through differentiation and reinterpreting them back into attachment theory doesn’t help anyone. The issue is not a theoretical one, it’s 100% practical: Is that what happened? Was the couple unattached or “out of connection”? Did they re-establish connection? Or was the couple emotionally fused? Was the active ingredient helping them become less emotionally dependent on each other, which allowed them to become more satisfyingly inter-dependent? That’s the 4 billion-dollar question, and it’s the middle and lower SES classes that most benefit from an accurate answer.
      I was really struck by your statement “Interpersonal neurobiology is in itself safety creating and brain changing.” I think it’s another example of how attachment theory has become so acculturated within our profession and the broader society. Out of respect for your kind reply I’ll share my thought: It’s absolutely true that interpersonal neurobiology is brain-changing, because it’s about how the brain changes interpersonally. But it is not true that interpersonal neurobiology is inherently safety-creating. That’s true only when you look at it narrowly through the lens of attachment theory, which says creating safety- (and hence secure attachment) is what things are really about. Unfortunately, a significant part of interpersonal neurobiology involves brain-changing trauma, haunting implicit memories, intrusive thoughts, right brain-left brain shutdown, and long-term low-mode functioning (“living regressed”). Interpersonal neurobiology is not “inherently” safety-creating
      Attachment-based therapy implicitly, if not explicitly, presents itself as the best platform for resolving these neurobiological problems. Some therapists believe modern brain research proves attachment theory is correct. My latest book, Intimacy & Desire, offers a differentiation-based integration of interpersonal neurobiology with a slew of references. This is very easy to integrate because Bowen was greatly interested in interpersonal brain function. But that doesn’t prove differentiation theory is correct or that differentiation-based therapy is best. The same is true with attachment-based therapy.
      I’m personally firmly convinced differentiation-based therapy provides a superior delivery system for applying interpersonal neurobiology. The lovely thing is, without a doubt, eventually this will be empirically determined. You better believe the insurance companies will get on board with whatever the answer is, which will shape psychotherapy more than anything we will say here.
      Thanks again for taking the time to respond.
      David
      Reply
  • Not available avatar Debra Tripp 04.26.2011 14:40
    Wow. I am quite intrigued with this topic, especially the 'tell it as it is' approach that recognizes AND NAMES human human tendency to selfishness and hurting back. Though I am more in the attachment camp and believe such things can stem from insecurity, I also recognize within humans the less than stellar qualities. My approch, however, has never been to leave a couple at the dependant/nurturant position, but call both partners to development and growth past that initial stage. Doesn't attachment therapy expect this growth? Debra
    Reply
    • Not available avatar David Schnarch 05.01.2011 15:06
      Hi Debra,
      Thanks for your response. All therapists know selfishness and hurting back can come from insecurity. The trouble is not all therapists are open to any other answer. Attachment-based therapists seem to know apriori that this is the cause in cases before they walk in. Starting with this assumption is not a good way to do therapy. I myself need to talk to clients in depth before I’m willing to stipulate to what is causing what. I like that you help couples move beyond focusing on nurturance and dependence, and nudge them to grow.
      I also love your question, “Doesn’t attachment therapy expect this growth?” Sure it does, and that’s the point. That’s the theory, but does it happen in practice? Does attachment-based therapy actually produce this growth? Is this the best way to achieve this outcome? Is differentiation-based therapy better? No one knows. But we’re never going to find out if we don’t ask the question. We’ll also never find out if we don’t distinguish between our theories and our praxsis.

      David
      Reply
  • 0 avatar Pauline Druffel 04.27.2011 22:42
    Networker technology staff, I hope you can help me. I was not able to listen to this session #4 until later in the day on Tuesday, and then I had to listen to it in two different sittings. Now I've wanted to go back to it again, or at least to the slides (although maybe there weren't more than two or three), but I find it impossible to get back to the session itself, the slides, or the MP3 that we are supposedly able to download when we paid the full amount, or back to any of the previous sessions. The good news is that I am able to get to these comment sections. Can someone please walk me through the process for getting back to any of the sessions that have already aired. I can read it here in this comment section. Thanks, Pauline
    Reply
    • 0 avatar Psychotherapy Networker 04.29.2011 14:51
      Hi Pauline,

      We're sorry to hear about your technology troubles! To listen or watch any of the sessions that have already aired, log into the website, hover (not click) your mouse over the Your Purchased Items tab, find Web New Perspectives, and click on Attachment. There, you'll find links to view or listen to the sessions, to the slides, and to the Comment Boards. If you have any additional issues, please feel free to contact support@psychotherapynetworker.org at any time. Hope this helps!
      Reply
  • 0 avatar robert kallus 04.28.2011 09:40
    David and Richard,

    First of all, Richard, I so appreciate the decision to include David in this conversation. Woe betide the therapist who becomes slave to any model or approach, and whose mind is closed to new possibilities. For those who were turned off, please consider this: maybe we need to be irritated now and then, to experience our own disequilibrium, just as we ask clients to experience, if we're going to grow, personally and professionally. Although trained in GST-based family therapy, I agree with David's assertion that the quality of relationship is largely determined by the individual's level of differentiation, capacity to self-soothe, resiliency, and so on. When all is said and done, it all comes down to the individual. In terms of process, one inference I take away is that the therapist - whether his/her personality is gregarious / blunt or easy-going, must be bold. If we're going to ask clients to have the courage to face the unknown, to change, to operate on a different plane, we'd bloody well better model that for them. I am intensely grateful for this reminder, David, and in two of my couples sessions yesterday, inspired by this presentation, I believe something good happened. By the way, David, if you remember at the Long Beach AAMFT conference, I'm the guy who told you that we read Constructing the Sexual Crucible in the MFT program at the Christian college in Arkansas.
    Bob Kallus
    Reply
    • Not available avatar David Schnarch 05.01.2011 15:18
      Dear Bob,
      Thank you for making my being the irritant more meaningful.
      Darn right we have to walk the walk and not just talk the talk. But I don’t think it’s about modeling. Mammals (and therapists) model, and there’s no doubt modeling in humans exists. But is that the most powerful element at work here? I would say we need to walk the walk because that’s how differentiation in the therapy works: A therapist cannot bring clients to a higher level of differentiation then he or she has personally reached. It has to do with anxiety regulation, emotional fusion, borrowed functioning, and that sort of stuff. In our trainings we don’t encourage therapists to think in terms of “modeling” because it leads them astray.
      I also have to say, I got a kick out of your own therapy being better from listening to my discussion with Rich. I get email all the time after a workshop, with someone saying they took a more differentiated stance with clients, or tried collaborative confrontation, or applied mind-mapping and noticed immediate positive results. I never get tired of hearing this. I discovered this same thing, which guided development of this clinical approach. It tickles me that you saw this for yourself.
      Your statement “the therapist must be bold” really got me thinking. Actually, I’ve been thinking and talking a lot about similar issues, because European therapists are very concerned about negatively influencing the therapy process. Showing them a therapy with more precision and scientific method than they knew took care of most of their concerns. With this as the backdrop to my answer, what’s wrong with a therapist being bold? Nothing. Better to ask, what kind of therapist are you if you’re not bold. Facing oneself and traversing the natural crucibles of emotionally committed relationships is not for sissies—or timid therapists.
      I do remember you saying at AAMFT that the MFT program at Christian College in Alabama use Constructing the Sexual Crucible. If your program was located in a Michigan land-grant college I’d be happy to hear this. But the school’s theological leanings and location in Alabama makes this even sweeter. Thanks for your continued interest in my work.
      (Other instructors who use CTSC, Passionate Marriage or Intimacy & Desire in your program, PLEASE CONTACT ME. We want to support your efforts. We have a devil of a time keeping track of all of you. Instructor evaluation copies of Intimacy and Desire are available for possible course adoption)
      Reply
  • Not available avatar James Jackson 04.29.2011 11:09
    The difficulty I have with Davids presentation is the assertation of objectivity or scientific approach without supportive data, if I understand correctly he is asserting (among other things) that he has created a tool to measure his constructs to begin research. This is lacking objectivity by desing and does nothing to help compair paradigm effectivness. Absolutely all therapy I veiw as constructive his presentation no less so than any other. The only useful construct that i was able to glean was danced around but not elucidated- being the importance of ego strength as a funciton of positive interpersonal relationships. I beleive it is quite debatable that differntiation is the only or even the best way to elicit sufficiant ego strength. I would be quite interested to see research and results.
    Reply
    • Not available avatar David Schnarch 05.01.2011 15:24
      Hi James,
      I appreciate your interest in objectivity, scientific approach, and supporting data. That is why I’ve spent several years working with Dr. Susan Regas of Alliant University to develop the Crucible Differentiation Scale (CDS), and pilot tested it with over 4,000 subjects. It has been accepted for publication by the Journal of Marriage and Family Therapy. Please be patient, as we have no control over their publication scheduled.
      I can say for a fact there was no dancing in my session with Rich—we were running, sprinting to lay out a complex discussion that easily could have gone hours, add case illustration, and pull it all together in 60 minutes. No topic got the coverage it warranted.
      Neither of these things makes me lacking in objectivity or avoiding detailed discussion. I just lack the power to make things happen as fast or as thoroughly as you and I might would like.
      You wrote that the only useful construct you gleaned was the importance of ego strength as a function of positive interpersonal relationships. You went on to say you took issue with differentiation being the only or best way to elicit sufficient ego strength. First off, I didn’t do the session to teach constructs. I did it to advance the idea that attachment-based therapy is, itself, a constructed reality warranting closer examination. Second, ego strength is a completely inadequate construct if you’re attempting to understand differentiation. Can you use reductionistic thinking to see similarities? Sure. But once you do and go off about ego strength, I really don’t have much to say about best ways to create it. I don’t have much interest is debating whether enhancing differentiation is the best way to create ego strength. I’m not interested in ego strength per se. It’s way too narrow a focus for me.
      Thanks for taking the time to write.
      Reply
  • Not available avatar Amy Olson, LCSW, CEDS 04.29.2011 13:02
    David,
    You seem to reference just poor therapy vs. poor attachment informed therapy. Any therapy that allows an individual to excuse their behavior due to FOO issues, encourages cheap forgiveness and only focuses on wounding is bad therapy. But I'm not sure if that is what is really going on in many of our offices. I believe we do our clients a disservice if we don't help them get their history straight. I feel it is impossible for an individual to move forward without this understanding. From there it's all about helping clients find internal resources to make responsible meaningful choices. I guess this could be called attachment informed and differentiation based therapy? This idea that attachment based therapy allows people to get off easy is nonsense. David you also must consider stages of change theory. Many people coming into typical OP therapy are in the early stages of change - too much confrontation makes them walk - think about Motivational Interviewing. Perhaps when you take so much pride in your great success rate, you should also thank the handful of talented, competent therapists who increased a client's readiness before they came to you - which I'm guessing no one does until the are really in an action phase. Overall thank you for a lively discussion - I like what you had to say about focusing on the best in people and applying prudent pressure - it really does strengthen the joints.
    Reply
    • Not available avatar David Schnarch 05.01.2011 16:19
      Dear Amy,
      Thank you for your kind words about creating a lively discussion, and your thoughtful response. I really liked your image of “strengthening the joints” through prudent pressure focused on the best in people. And no good deed shall go unpunished. I’ve thought at length about many points in your post. I hope this lengthy response is useful.
      You wrote, “I believe we do our clients a disservice if we don't help them get their history straight.” I agree with you in large part, but herein lies thorny issues because this is not as straightforward and simple as it may seem. First, some; people want to get lost in “one more trip down memory lane” rather than deal with pressing or long-avoided issues. This can happen in any therapy, but I think this is an especially slippery slope in attachment-based therapy.
      Second, many therapists are blind to the fact that “helping clients get their history straight” is dramatically shaped by the therapist’s organizing theory, because this not only tells clients and therapists “where to look,” it also greatly influences how clients and therapists “package” (co-construct) clients prior history in the process of “deconstructing” it. This is true in any clinical approach, including our own approach, and when we train therapists we keep this front and center all the time. I think therapists are now so enthralled with attachment-based therapy, they lose sight of issues of social construction and being “captured by the paradigm.”
      Third, I’ve seen people who’ve had years of unsuccessful therapy tell me their life story and family history, the one consensually-validated by multiple therapists who were unable to help them. When we go over these stories in differentiation-based therapy, the story looks completely different.
      Fourth, many therapists today are agog about interpersonal neurobiology and autobiographical memory, but they really can’t imagine the staggering FOO distortions many clients bring into therapy. They think the client basically has the story straight, but simply hasn‘t come to grips with it, and if they provide a “safe environment” and plenty of nurturance and empathy, the client will finally do so. I don’t think attachment-based therapy provides an optimal basis for the collaborative confrontation necessary to get a straight story.
      My point is not that attachment-based therapy lets people “off easy.” There is nothing easy about being in therapy that doesn’t help you deal with hard things you’re avoiding—because you have to live with the (lack of) results when you’re out of the therapist’s office. I wouldn’t call this getting off easy.
      You say you feel it is impossible for an individual to move forward without understanding her past, and a great many therapists share your views. However, several people in these posts have taken me to task for lack of objectivity or scientific data. Here I’d like to point out there is no objective data to support your assumption for therapy, and lots of real life case examples demonstrate this to be false. Lots of couples, parents, and families have to move forward and make decisions without understanding their family of origins (e.g., marriages fragmenting over the stress of a child with leukemia). I think you articulate a particularly American view where ongoing therapy is almost a birthright. The rest of the world, particularly people in third-world countries, don’t necessarily believe in or have the luxury of this assumption.
      You go on to say, “From there it's all about helping clients find internal resources to make responsible meaningful choices.” I don’t think it’s all that simple, because the paradigm in which therapy has been conducted up to that point (in establishing early history), greatly influences clients’ ability and willingness to find those resources and make responsible choices.
      You write, “I guess this could be called attachment informed and differentiation based therapy?” I guess you could call it this, but giving something a name (that describes the therapist’s intent) doesn’t mean the therapy has the function or operation the name implies. Many therapists don’t want to deal with the fact that not all ideas or approaches fit together (as recognized by Merrilee’s post). They attempt to straddle fundamental differences between attachment-based and differentiation-based therapy by simply thinking they are successfully homogenizing the two. In two decades of training therapists, many of whom were attachment-based therapists, I’ve seen lots who attempted this. Pragmatically, I’ve seen it doesn’t work. “Doesn’t work” meaning you build in contradictions and end up crossing your own lead, or the interventions are non-isomorphic, or you lose the power of differentiation-based therapy.
      I also like two issues you implicitly bring up: One is industry standards for “pace of change,” and therapists can use stage of change theory to validate them. From my experience, therapy can be done far faster and more effectively than many clinicians think. We don’t like to consider how conventional practice shapes our view of people’s ability to change. There’s no getting away from the results we see in our own practice shaping our views, theories, and expectations. This become problematic, when we assume we’re seeing how fast people can change, rather than how fast WE can help them change. The psychotherapy industry likes to assume we’re seeing people’s (in)ability to change, rather than we’re seeing the current state of psychotherapy.
      The other quagmire is the conglomerate of issue surrounding “too much confrontation.” We love to think this is primarily determined by client variables. We don’t like examining:

      1.Industry notions of what constitutes “too much confrontation”

      2. Therapists’ differentiation level greatly shape what they themselves consider “too much”

      3. Therapists’ differentiation greatly controls their ability to use confrontation effectively.

      4. Therapists’ conflict of interest between keeping clients in treatment during early stages of therapy, vs negotiating expectations for effort and discomfort which also occur in initial sessions.
      5. Clients who faithfully and frequently return to their therapist’s office because they are not actually in treatment.
      On top of all these practical issues, lies thorny paradigmatic dilemmas. Here’s what we teach in our training: The impact of an intervention made by a therapist is more determined by the paradigm it is embedded in rather than the therapist’s intent. You’re absolutely correct that if you turn up the heat in attachment-based therapy, clients are more likely to walk out. That’s in part because the therapy has set up expectations making client more likely to walk out when confronted, because this is supposed to be about feeling secure, accepted and empathized with. The same move in differentiation-based therapy has a different impact that is better tolerated by clients, and this is an easier paradigm within which to conduct collaborative confrontation. This is hard for attachment-based therapists to keep in mind when they say, “you can’t do that!”
      I really like your statement “…you should also thank the handful of talented, competent therapists who increased a client's readiness before they came to you - which I'm guessing no one does until they are really in an action phase.” It made me think a lot. Actually I do thank such therapists, and so do their clients. It’s a huge win for everyone involved. If that isn’t clear, I should make it more so. (But I also have difficulty with the picture that we get good results because other therapists have done the sweat-labor and we skim the cream off the top, or that I see “better clients who are farther along.” I see what heretofore have been untreatable couples.)
      There are other important assumptions and issues floating around in your post that allows therapists to maintain a self-serving picture of therapeutic reality. The public and our clients would be better served by us confronting ourselves about them:
      • Unfortunately, some therapists increase their clients’ readiness to see me by the LACK of progress, rather than preliminary growth, occurring in the prior therapy.

      • I don't think it's true that people don’t come to see me until they are really in the action phase. Think about it: if they were really in the action phase of “stages of change,” they wouldn’t need to come see me. They’d be able to make changes with their local therapist. Or maybe they wouldn’t need treatment at all. No, the people who come to see me generally aren’t in the action phase. They’re often coming to see me because their lives are falling down around them, they can’t maintain the status quo anymore—and they still don’t want to change.

      • Forget the idea that the very fact they flew to see me demonstrates their readiness to change. From experience, I don’t accept that when my clients run that past me. That’s a very naïve view of what motivates people and how hard it is to change. Many clients spend good money on therapy as long as they DON”T have to change. This goes on with local therapists as well as those who come to see me.

      • We see loads of couples on the verge of divorce. Many aren’t in action mode, they’re making a final effort to preserve inaction mode.

      • “Stage of change” thinking wipes out the reality that people often make dramatic changes in crises. Crisis is something you’re not really prepared to handle. “Stage of change” thinking too readily supports the ‘baby step” approach common to attachment-based therapy.
      • Life, marriage, families and parenthood don’t pay attention to one’s “stage of change.” We need to stop doing therapies that implicitly or explicitly tell people they don’t have to deal with things that are way beyond what they’re prepared to handle. Similarly, we therapists have to start jumping into issues we’re really not prepared to handle if our field is going to progress.


      I hope you take this long response as thanks for your post.

      David
      Reply
  • Not available avatar gayle goodman, psyd 04.29.2011 14:30
    we need to remember that healthy development of self includes attachment, internalization of the other, and finally, differentiation with a healthy sense of self and strong emotional boundaries. differentiation is built on the platform of a secure, trusting and responsive relationship. but cannot be hammered in to someone. schnarch makes a valuable contribution in emphasizing the role of differentiation as crucial, but misreads attachment theory if he thinks that part is left out-not in good practice, it isnt. as he points out, its not an either-or connundrum.
    Reply
    • Not available avatar David Schnarch 05.01.2011 16:32
      HI Gale,
      I appreciate you taking the time to add your thoughts. I know many therapists resonate with you when you say we need to remember “differentiation is built on the platform of a secure, trusting and responsive relationship.” This is certainly attachment theory dogma, the “first you have to attach before you can differentiate” credo, but there is no research to back up this “assertion of necessity.” (Here’s a place where 45227burikjwo4 and Steve Nasuta, who demanded objectivity and research data in earlier postings, ought to turn the same lens on attachment-based therapy.) So I don’t think we need to remember this yet. First we need to find out if it’s true.
      Lots of everyday examples say this isn’t necessarily (and often isn’t) true. In fact, there are lots more examples of people becoming more differentiated in the absence of a secure, trusting and responsive relationships. Moreover, some collusive marriages and families that masquerade as “secure, trusting, and responsive” are actually the hardest in which to become more differentiated.
      Necessity, and not secure attachment, is the mother of differentiation. This has been born out throughout recorded history. You’re absolutely right that therapists can’t hammer differentiation into people. But therapists also have to get real that life, marriage and parenting hammer us into more differentiated adults. Our industry and the public at large would be better off if we stopped repeating attachment-based truisms that are patently false in many ways, and which rationalize and preserve prevailing modes of practice that merit serious scrutiny.
      I don’t mean to offend you, when you were motivated enough to write a comment. And I know it can sound like I’m just critiquing attachment-based therapy without laying out what I think is a better way to do things. If you’ll bare with me for about two weeks, I’ll point you to easily accessible material that lays out what I think. I’m preparing a series of blogs for Psychology Today and the new Intimacy and Desire web site we’re about to release. They offer a completely different view than “first you attach and then you differentiate.” Once they are posted, I’ll be interested in your reactions and thoughts on this issue.
      Thanks for writing,

      David
      Reply
  • Not available avatar Kristen 04.30.2011 16:05
    Attachment theory recognizes the need for (1) a "safe haven" that we can turn to in distress, and (2) a "secure base" that we can explore from as individuals. In other words, healthy attachment includes both dependency and individuality. It might sound paradoxical, but even Erickson recognized this when he stressed the need to develop a strong, healthy identity BEFORE one could develop strong, healthy relationships. My point: I don't believe that differentiation and attachment are as dichotomous as we make them. Why can't we be able to "stand on our own two feet" (i.e., self-regulation) and be vulnerable with others in both intimacy and distress (i.e., mutual regulation)? I choose both!
    Reply
    • Not available avatar David Schnarch 05.01.2011 16:44
      Hi Kristen,
      Your comments highlight a variety of really crucial points. Perhaps the most important is when you ask “why can’t we stand on our own two feet and be vulnerable with others at the same time?” You then state you choose both. However, the issue is not your principles or your intent, it’s about doing psychotherapy. And you can’t do everything in therapy. Time and financial constraints dictate that a therapist decide what he or she will do, and this is determined by what she or he thinks is most important to accomplish this in therapy.
      So the issue is not whether the concepts of differentiation and attachment are dichotomous. This is not about rhetoric or theory. One issue is what are you going to do in treatment because you can’t choose to do it all. The other is, if you’re operating in the “first you have to attach before you can differentiate” there’s the pragmatic problem that if the therapy doesn’t deal with attachment issues quickly and efficiently, there’s not much time and money left to get to differentiation issues in depth. And if you don’t get the attachment issues resolved per se, you don’t get to differentiation at all.
      Eventually this question will be answered empirically: Does attachment-based therapy or differentiation-based therapy do a better job of producing both attachment and differentiation. My money says differentiation-based therapy is superior producing attachment and differentiation.
      Now that our focus is on doing therapy, another issue surfaces: strategies and interventions in attachment-based therapy and differentiation-based therapy are often diametrically opposed. Saying you choose both attachment and differentiation doesn’t solve the problem, and doing “a little of this and a little of that” produces a non-isomorphic therapy with minimal forward drive that’s probably the worst of all possible options for producing attachment or differentiation.
      These are two huge issues, and you’ve got another hidden block-buster in there. Your comment brings up is a serious industry-wide problem that presumes vulnerability is a virtue (e.g., “be vulnerable with others in both intimacy and distress”) and confuses vulnerability with openness. Vulnerability isn’t a virtue. People are open when they aren’t vulnerable. This bass-ackwards construction of how intimacy operates creates an invisible iatrogenic boondoggle that limits treatment progress and effectiveness. This gets even more schizophrenogenic: Attachment-based therapy keeps promoting the very vulnerability it then says is at the root of relationship problems, and should be the core focus in of relationships (e.g., “safe haven” and “secure base”).
      I limit myself here to saying “mutual regulation” is as big a boondoggle as the one I just described.
      Thanks for your post.
      Reply
  • Not available avatar Renee Segal, MA, LAMFT 04.30.2011 16:21
    I am still awed by the comment that attachment based therapy is a social construction. Your comment about the imaginary couple dealing with infidelity related to trust of the partner versus self trust is right on the mark. This seems to be true with a lot of the couples that I see. What I found most interesting was the way you structure the session. I found myself thinking that you are a combination Carl Whitaker's and the strategic therapists of the 1970's because you are really setting up a paradox for the hurt partner.
    Thanks for a provocative session. I am off to find your book
    Reply
    • Not available avatar David Schnarch 05.01.2011 16:55
      Thanks Renee!
      Glad you picked up on my social construction comment. If you’re awed it means you cracked the veneer, shifted realities and saw this possibility for yourself. It’s like realizing the Matrix exists, except it’s never too late to “go back to sleep.” Given this, I’m not surprised you liked my redirection of traditional approaches to “trust.”
      When my work first become known after I published Constructing the Sexual Crucible (CTSC) in 1991, lots of people said I reminded them of a young Carl Whitaker. I don’t hear “young” any more, but thanks for the comparison. I was quite interested in paradox back then, although I my approach differed from 1970’s strategic therapists. They were interested in what I called “constructed paradox” (where the therapist constructs the bind). I was interested in using “inherent paradoxes” built into emotionally committed relationships. I actually wrote about this at length in CTSC. If you’re interested in paradox, you might want to take a look.
      If you’re interested in how I set up the case I described, I worked it more from isomorphic intervention than paradoxical intervention. Ruth happens to be doing a workshop this weekend at the AASECT annual meeting on “isomorphic intervention.” She called to say she went back and read about isomorphic intervention in CTSC as part of her preparation. She said she had forgotten how good this material was.
      Although CTSC is 20 years old, it’s still required reading in many psychotherapy training programs of various disciplines. In a prior post, Bob Kallus said the MFT program at the Christian college in Arkansas is one example. You’ll probably find Intimacy and Desire and Passionate Marriage are much easier reads. CTSC has 650 pages and 700 references, and it ain’t cheap.
      Thanks for taking the time to write.
      Reply
  • Not available avatar Gail Smith LCSW 04.30.2011 19:55
    Great session. I am currently working with an older couple coping with an affair. It has become obvious that they are looking for differentiation within their marriage. The affair appears to have brought their dissatisfaction with their own lives into the light. I appreciated David's view of the blunt realities of relationships and agree that forgiveness of bad behavior can reiforce idea that bad behavior is forgivable (not just for the other but for the self. Neurobiological changes due to behaviors and relational feedback loops is certainly the future of psychotherapy. Thank you.
    Reply
    • Not available avatar David Schnarch 05.01.2011 16:58
      Thanks Gail,
      Glad you liked the session. To pick up on my prior reponse to Renee, if you’re working with a couple coping with an affair, Constructing the Sexual Cruicible has an entire chapter on affairs, laying out a complete differentiation-based intervention strategy. It’s dramatically different than attachment-based approaches. So different, in fact, it illustrates:
      • why I said to Kirsten that her “I choose both” approach is not likely to work
      • my caution in prior responses about therapists “crossing their own lead”
      • my lengthy comments to Amy about “too much confrontation” being a function of the therapy approach it’s embedded in.
      If you take a look at CTSC, let me know what you think.
      Reply
  • 0 avatar Martha Landman 05.01.2011 02:49
    I agree to a large extent with Toni Herbine-Blanks's comments. I trained in Imago Therapy in the early '90s, but then moved on to trauma therapy, EMDR and Brainspotting. When I first read David's Passionate Marriage I fell in love with his work. Schnarch, Harville Hendrix, John Gottman and Albert Ellis are the people who guide me when I do see couples.
    The way I see David's work is very much the same as Milton Erickson - both are so individual in their approach and so attuned with their clients that it is hard to teach their approach. To be able to "be seen" by the therapist and then to be called on to bring forth the best in you is the greatest gift a therapist can offer. This is what the parents might have been unable to offer and hence the need for therapy.
    Reply
    • Not available avatar David Schnarch 05.01.2011 17:05
      HI Martha,
      Thanks for including me in the pantheon with Hendrix, Gottman, Ellis and Erickson. You’re dead on about being seen and called on for the best in you to stand up. It is indeed one of the greatest gifts a therapist can offer. Not uncommonly, clients’ response to the gift is often, “Fuck you very much!” (said smiling). That’s why the gift frequently isn’t offered.
      Not too long ago, your comment about Erickson’s and my approach not being teachable would have troubled me. For years I’ve heard similar comments, and I’ve worried this could be true. But I don’t worry any longer, because the process of developing the neurobiological aspects of my approach led me to refine and boil down the methodology of Crucible Therapy as a whole. By my estimation it is now highly teachable, and we’re changing how we teach it, starting with mind-mapping.
      What isn’t “teachable” is the therapist’s differentiation, which is the limiting factor in any therapy and especially critical in my approach. The new 4-day workshop series we’ve developed seems to do a good job of stretching therapists’ differentiation, if the three programs I just did in Ulm, Bochum, and Berlin Germany are any indication. Ruth Morehouse and I are offering this program in Los Angeles in November if you’re interested.
      I’m certainly biased here, but I’m impressed with how much we can now teach a scientific-method-based therapy and grow therapists in 4 days, especially if they’re willing to temporarily leave behind attachment-based therapy and try a completely different way of conducting treatment. It can be disorienting at first, for which I make no apologies.
      Thanks for writing in.
      Reply
  • Not available avatar Niquie Dworkin 05.01.2011 08:07
    I agree with several previous comments that suggest Schnarch has set up attachment theory as a straw man. While there are certainly many therapists of all orientations that may collude with clients' defenses and fail to challenge them, there is nothing inherent in attachment theory that recommends this. Schnarch's "disgusting" parent sounds just like attachment theory's chaotic or intrusive parent, who very well might promote unhealthy dependence and lack of differentiation. Obviously a therapist who repeated this pattern would be harming a client. The balance between a nurturing and a confrontational approach has been ongoing since Freud and Ferenzi and will continue, as it is easy to err in either direction. Of course it is always problematic for therapy to be conducted in a pat or unthinking manner and attachment theory may lend itself by its very label to being misunderstood as fostering dependence. But if understood in its complexity it can account for the co-construction of both mind experience and biological brain structures, and in doing so must ultimately place the responsibility on BOTH participants, which provides a corrective to a one-way, regressively dependent relationship.

    Thanks for a very stimulating program.
    Reply
    • Not available avatar David Schnarch 05.01.2011 17:25
      HI Niquie,
      Thanks for your post. You write Schnarch's "disgusting" parent sounds just like attachment theory's chaotic or intrusive parent, who very well might promote unhealthy dependence and lack of differentiation. Obviously a therapist who repeated this pattern would be harming a client.”
      Here I assume you mean the therapist promotes an unhealthy dependence and lack of differentiation, and not the therapist is disgusting like the parent. I, on the other hand, am quite serious about discussing disgusting parents (and therapists). Like the therapist who treated the same client for 25 years (the client eventually came to see me because his relationship was falling apart.) Calling this promoting an unhealthy dependence doesn’t begin to describe what the therapist was doing. This was so disgusting (like the clients parents), the client didn’t let himself to see it for what it was, never confronted the therapist, and stayed in treatment.
      I presume someone’s going to nail me on the grounds I’ve chosen an extreme example. But my point is three-fold. First, this example exists because this problem exists; I’ve seen any number of cases where someone is in treatment for 5-10 years and the only time the therapist actively confronted the client was when he or she attempted to terminate.
      Second, it illustrates how dropping reality into attachment theory’s “chaotic” and “intrusive” cubbyholes sanitizes rankness and depravity by not really focusing on the dark ends of the continuum.
      Third, we’re not talking about attachment theory, we talking about attachment-based therapy and the pragmatics of treatment. Just because you can stretch a theory to cover really “dark” family and personal dynamics, it doesn’t mean the result is the approach of choice for addressing these issues with clients. Rather, I think you end up with a clinical approach that doesn’t facilitate therapists going there.
      You note it is easy to err in either being overly nurturing and confrontational. This suggest therapists walk a fine line, that therapists are equally prone to error in either direction, and that being nurturing and confrontational are antithetical. I strongly disagree with this juxtaposition. Collaborative confrontation nurtures growth, and as such is the embodiment of true empathy. I think the proper juxtaposition is between the error of making trivial stereotypic “empathic responses” and the error of combative confrontation. Moreover, my experience in training therapists is they are far more prone to make the former error. It is, in part, because they’re don’t collaboratively confront clients on a regular basis, that when they do confront clients they do so combatively rather than collaboratively. Far more therapists are worried about being too confrontive than are worried about having a collusive alliance with clients. (Look at the thread of these posts for example.)
      You suggest attachment theory may lend itself to being misunderstood as fostering dependence. I think the problem is that attachment-based therapy fosters blindness to the dependence it fosters. This harks back to the notion of walking a fine line. I don’t think it is a fine line, it is very broad with a lot more latitude than therapists seem to think, particularly when it comes to collaborative confrontation.
      Here’s a further example why I don’t think therapists are equally likely to make the dual errors you pose. I think a majority of therapists will agree that if they are going to make an error, they darn sure want that error in the direction of being too nurturing rather than too confrontive. (I don’t agree with this stance.) They are particularly sure this is the preferred error to make if they do attachment-based therapy. Again, in practice, this isn’t a fine line, attachment-based therapists are particularly likely to give confrontation a wide birth. Wouldn’t want to threatened the attachment relationship between client and therapist, particularly since therapy is suppose to provide a corrective experience.
      Am I saying no attachment-based therapist confronts his or her clients? NO. I’m saying the theoretical landscape of attachment-based therapy doesn’t lend itself to a balanced stance in which both errors are equally likely.
      I completely agree that attachment-based therapy must ultimately place the responsibility on BOTH participants. However, the fact attachment theory can account for the co-construction of both mind experience and biological brain structures proves nothing about its relative utility as a platform for adult psychotherapy, especially dealing with couples, and particularly about sex and intimacy. In Intimacy and Desire, my most recent book, I accounted for mind-experience and brain structures from a differentiation-process perspective. Participants in this discussion aren’t about to accept that my therapy is therefore effective.
      Moreover, attachment theory’s “accounting power” doesn’t prove attachment-based therapy is inherently structured and operates to insure placing responsibility on both partners. When I train therapists in my approach, we explicitly teach making balanced interventions. Many therapists are shocked to realize they aren’t use to making them.
      Attachment-theory based therapy encourages therapists to align with people’s fears and insecurities, and thus the therapist easily ends up too aligned with the client with the most fears. Fears and insecurity are the trump card in attachment-based therapy. When I read Sue Johnson’s wonderful JFMT article on sexuality, I don’t see her having a balanced alliance that places equal responsibility on both partners. Moreover, for the most part responsibility is not a common word or intervention-focus in her description of her work. Fears, anxiety, and insecurity are front and center in word and intervention.
      All of this responds to your statement there is nothing inherent in attachment theory that recommends colluding with clients' defenses and failing to challenge them. Is there an explicit recommendation to do this? Obviously not. Does attachment-based therapy unwittingly encourage this in practice? I think it does.
      Reply
      • Not available avatar Niquie Dworkin 05.02.2011 15:58
        David-

        Thank you for your thought provoking comments. I really been giving them serious consideration. You are right, of course, that the current bias is strongly in the direction of nurturing and support, but this has not always been the case. When Alexander and French first introduced the notion of the corrective emotional experience, they were all but excommunicated. Therapists were under no circumstance to "gratify" their clients. Attachment theory and the relational movement were in large part reactions to this forbidding stance. Another reason therapists have moved in this direction is, ironically, the recognition that the relationship is co-constructed and that the therapist is not an infallible authority with a monopoly on the truth. The potential pitfall of the confrontative stance is promoting what Paul Wachtel calls "the school of suspicion," a therapist who feels entitled to say she "knows" what is truly going on inside the patient. Have we now swung too far in the other direction? I would say yes. Do we need a corrective? Absolutely. Does this entail yet another completely new theoretical system? I am not convinced. I understand the fine line between integration and what you call "garbage can eclecticism," but I would like to struggle dialectically a little longer before jettisoning what we have accrued so far and starting over.

        Thanks again,

        Niquie
        Reply
        • Not available avatar David Schnarch 05.03.2011 08:52
          Dear Niquie,
          Thanks for taking my comments seriously and responding in kind.
          I agree that the bias towards giving collaborative confrontation a wide birth comes, in part, from “the recognition that the relationship is co-constructed and that the therapist is not an infallible authority with a monopoly on the truth.” The therapists in Germany were extremely concerned about this point. But my point to them, and to you, is that error bias towards being nurturing when we should be challenging does not make therapists less fallible. It just adds another failing. Being non-confrontive is not a solution to the problem of therapeutic fallibility or the enormous power and responsibility of being a therapist.

          There is NO approach or clinical strategy that will get you out of this huge responsibility. (Aside from fallibility, and no monopoly on the truth, you also left out therapist values. There is no such thing as a value-free therapist, and a value-free therapists would be useIess and unable to function in therapy.) I think it’s better for clients that we sweat this forever, rather than think we’ve found a way around this. Better we constantly worry what we’re doing with a laser-knife than do surgery/therapy with a butter knife thinking we can’t do much harm. I constantly worry about this because I think therapy that doesn’t really help people get as far as they can go, as fast as they can go, and taps out their financial resources and uses precious time is contrary to clients’ best interests. When the best in me worries about this, it doesn’t immobilize me, it increases accuracy, eliminates complacency, and pushes me to keep looking for better ways to do therapy.

          I wish the “no monopoly on the truth” therapy-thinking would collide with “brain science proves attachment theory” research-thinking, because all that lovely brain research don’t prove that what attachment-based (or any other approach) therapists do is correct.

          Is it better to error in being overly nurturing and not really getting into what’s going on, than be overly-confronting? I’m not advocating the latter, I think it IS important to do therapy where you are equally likely to make BOTH errors, and work you tail off to reduce the margin of error in both directions. Here’s where accuracy, precision, and scientific method in doing therapy comes in.

          The biased concern towards being too confrontational that’s dramatically evident in many posts in this thread is caused by (a) therapists’ preference to make errors of omission than errors of commission, (b) therapists’ need for clients to like them (reflected sense of self), and (c) attachment-based therapy’s theoretical emphasis on (1) empathy, (2) viewing the treatment alliance primarily as an attachment relationship, and (3) asking clients to trust the therapist. Aside from the thorny question of why the client needs to trust the therapist, and trust them for what(?), doing therapy where the therapist encourages the client to trust her means that when the therapist repeatedly makes the error you and I agree they are prone to make, the client stays in therapy. I don’t think this is good for clients.

          Therapies that induce clients to trust the therapist are especially dangerous to clients, and inordinately increase therapists’ error bias to not appropriate confront and be superficially nurturing. Therapists are too worried about clients leaving therapy. I think when therapists are making repeated (and especially, systematic) errors clients SHOULD leave, and find a better therapist. The problem with therapy based on inducing clients to trust the therapist is that it makes clients too likely to stay when they shouldn’t. Clients don’t become psychotic when a therapist makes a mistake of being overly or combatively confrontational, they just leave (as they should) and they find another therapist. It’s the therapist who becomes psychotic when clients leave, because they’ve lost income and have a reason to question their therapy. I think therapists are more worried about keeping clients in therapy than they worry about doing somewhat effective therapy. This is not in clients’ best self-interest, and touches on a conflict of interest in our industry that needs to be more openly discussed.

          The logical argument, “How can you do therapy if clients are always leaving therapy?” is actually illogical. My clients really trust me and they don’t leave, but I never encourage this directly and I confront clients when they tell me too early in treatment that they trust me when it isn’t warranted. They trust me because of how I perform over time, not because it is pivotal conceptual treatment concept.

          I like Paul Wachtel’s concern that confrontation can promote an adversarial stance (“the school of suspicion”). He’s got a good point. Here attachment-based therapy’s perpetual analogy of therapy to parenting is instructive. A parent who takes a suspicious adversarial dubious stance towards their adolescent is tragically ineffective. But so is a naïve “goody two shoes” parent, who doesn’t really get involved with the child, or deal with what the child is (not) doing, but praises the child profusely and empathizes with them. The latter parent (and therapist) is often far more difficult for the child (and client) to deal with. A good parent doesn’t bet against their child, but she sure keeps a vigilant eye on her kid, and asks questions the kid doesn’t want to answer and the parent doesn’t want to ask.

          Loved your statement about “a therapist who feels entitled to say she ‘knows’ what is truly going on inside the patient.” Many therapists who are agog about brain science don’t realize how far the implications really go. It requires a change in stance that pushes a therapist to confront shibboleths in our field. Mind-mapping ability obviously isn’t always perfect, but mind-mapping DOES allow one person to know what is truly going on in another person’s mind. Many people know their parents’ minds better than the parents know themselves. This is just one way psychotherapists have not really grasped the clinical implications of what brain science is ushering into our profession. Parents damn well better “know” what’s going on with children, and the same with therapists and their clients. Can either one be wrong? Sure! Parents have to sweat this all the time, because they don’t have the luxury of just sitting back and empathizing because they might be wrong. They often have to collaborative confront their kid all the time. Therapists have to do similarly.

          You write, “Does this entail yet another completely new theoretical system? I am not convinced...I would like to struggle dialectically a little longer before jettisoning what we have accrued so far and starting over.” Niquie, if you do that, my goal has been accomplished and my efforts are worthwhile. Nothing would make me happier.

          Thanks for making me happy!
          Reply
  • Not available avatar Thomas Nolan LCSW 05.01.2011 21:29
    Just listened to the Webinar tonight. Very provocative..I received more from the many honest and insightful postings than the one hour webinar. I am a Bowenian-trained FST and been practicing for many years. I love the idea of collaborative confrontation as well as holding each couple accountable for their implicit, collusive and tenacious "holding on" to what they know. Collaborative confrontation implies to me some kind of "connection" in therapy in order to engage the client in looking at "what is" in their relationship...and ultimately in themselves. The quality of attachment experience is a factor (plus or minus) in engaging this process but I don't think it's the determining issue. How and under what circumstances will the client really look at themselves? I've seen many individuals with many difficult early-attachment experiences who have decided to grab hold of their lives and make it work. What are those factors and how can we dare to employ them? This presentation helps me look more at "me" and what I'm doing.
    Reply
    • Not available avatar David Schnarch 05.03.2011 08:57
      HI Thomas,

      Really liked your comments, especially recognizing collaborative confrontation a type of connection and form of engaging clients. You say you’ve seen many individuals with many difficult early-attachment experiences who have decided to grab hold of their lives and make it work. If you have, you’re a good therapist and your clients are lucky. If you’re reaction to the webinar was to look more at yourself and what you’re doing, I’m not surprised.

      What I liked even better were your questions! How and under what circumstances will the client really look at themselves? What are those factors and how can we dare to employ them? Why not use this opportunity to push yourself, dare to lay out some preliminary answers based on your clinical experience. Most people here seem to think the answer is first and foremost, “secure attachment.” You say you think attachment is a factor but not the determining factor. What do you think are stronger determinants?
      Reply
  • Not available avatar Scot Liepack 05.02.2011 00:50
    I found Dr. Schnarch's presentation more interesting and provocative when I took it as a "stand alone," outside of the debate on attachment. As compared to Dr. Siegel, for example, who clearly sites a significant amount of high quality research for the basis of his assumptions, Dr. Schnarch's initial assumptions were stated as truth, without references to back them up. The problem is that his assumptions do not track at all with what I do in therapy or with what I have learned from the multiple conferences on attachment theory and practice or from reading the many books in the Norton series of Interpersonal Neurobiology and others. As much as I am really appreciating this series, I would ask Dr. Simon to either insist on speakers presenting the data to support the initial framing of their presentation or to facilitate dialogs between presenters who can challenge the framing assumptions.
    Reply
    • Not available avatar David Schanrch 05.03.2011 09:00
      HI Scot,

      Actually, I’m delighted you find my assumptions and thesis does not track at all with what you have learned from multiple attachment conferences and the Norton series. That’s my point. Attachment theory and attachment-based therapy is a world unto itself. Also, I like your clear statement that what I’m describing does not track at all with what you do in therapy. That’s another point I’ve been making to the people who think they can homogenize differentiation-based therapy and attachment-based therapy.

      Thanks for writing in.
      Reply
  • Not available avatar Joy Lang, RSW 05.02.2011 12:05
    Thank you very much Dr. Schnarch for a thought provoking presentation. I like very much the "tell it like it is" style, but I'm having difficulty reconciling the amount of confronting in this model with how I currently practice with my clients. I am off to pick up some books that will hopefully help me to be able to imagine how I might be able to do this with some of my clients. Thanks again for a very thought provoking presentation!
    Reply
    • Not available avatar David Schnarch 05.03.2011 09:01
      Hi Joy,

      Your post gives me a chance to pick up what I wrote to Scot and refine it. “Tell it like it is” does not need to be harsh. It is real kindness and can be delivered as same. Some people here have characterized their take on my therapy as “in your face,” which I don’t agree with. I do live demonstrations all the time, and people are usually surprised that my actual style is often softer than they anticipate, although is definitely “tell it like it is.” If you are my client and you’re screwing with the truth or trying to walk around my questions, can I “get up in your face?” You bet. Can I get “tough” when I have no traction with clients? Absolutely.

      But there is no purpose and much wrong with constantly coming across as a tough therapist. I have highly manipulative clients who come to see me saying, “I hear you’re tough. I don’t want you to let me get away with anything. I want you to confront me and kick my ass.” My response is to say, “If that’s what you want, here it is: If you want your ass kicked, kick it yourself. Where should we start?”

      Good collaborative confrontation doesn’t emphasize confrontation, it emphasizes a type of collaboration. If you focus on this, and you like “tell it like it is”and aren’t wedded to a “safety and security” model, it will be much easier to integrate into your practice. Books are great, I write them myself, but they are no substitute for clinical training.

      Good Luck!
      Reply
  • Not available avatar Audrey "Kixx" Goldman, EdD 05.02.2011 15:17
    Thank you Dr. David Schnarch. I've always thought your ideas challenging and this was no exception. Whenever I find myself alone and laughing out loud in a charged way, I know your point has hit home. I loved your description of the 'characteristics of your failures.'

    In addition to systems theory, I am a student and researcher in emotionally focused couples therapy and it has been the premise of much of my practice with couples.

    I am considering returning to couples work after a hiatus but have had some reservations as to whether I would feel inspired and effective in my approach. The Crucible approach may provide further needed inspiration and motivation.
    Reply
    • Not available avatar David Schnarch 05.03.2011 09:02
      Hi Kixx!

      If you’re alone and laughing out loud in a charged way, then I too know my points hit home. Thanks for laughing and sharing!

      Lots of EFT and Imago therapists come for training because they’re looking for inspiration and greater efficacy in their therapy. You’re welcome to attend our 4-day November program in LA. (http://crucible4points.com/2011clinicalworkshopla) If you attend, be sure to come up and reference this interaction. It would be a pleasure to meet you!

      Kind regards and good wishes.

      David
      Reply
  • Not available avatar Evelyn Peckel 05.02.2011 18:49
    I thought attachment theory included also bad attachmente styles like the ones David is describing. He is excluding it as if attachmente therapists only consider attachment as good love. I didn't have that idea of att theories. For me bad parents also make attachments
    Reply
    • Not available avatar David Schnarch 05.03.2011 09:03
      Hi Evelyn,

      It’s clear bad parents make attachments, and attachment theory takes this into account. Isn’t that what “chaotic” or “intrusive” parents are? See Niquie’s original post and my response which addresses this very issue.

      Thanks for writing.

      Reply
  • 0 avatar Charlie Love 05.02.2011 19:52
    Listen to this late.
    Thanks to everyone for contributing to this lively debate.
    I am an Imago Therapist but appreciate David's focus on buiding self reliance.
    Charlie Love, MS, LPC, LMFT
    Austin, Texas
    Reply
    • Not available avatar David Schnarch 05.03.2011 09:04
      Hi Charlie,

      Glad you like this thread. It certainly is joint effort to bring this discussion forward. Again, we should include thanks to Rich Simon for giving us the vehicle to do this.

      Thanks for participating.
      Reply
  • 0 avatar Jennifer Ryan 05.02.2011 21:43
    Dr. Schnarch,

    I had the pleasure of hearing you at SMU in Plano, TX recently, and was glad since I'd read "Passionate Marriage." Plus, one of my office mates is a David Schnarch wannabe, so I had to see you in action for myself.

    That said, I took then, and in this presentation, some good information. (The SMU talk was richer, frankly, because you discussed what your own philosophy IS as opposed to what it ISN'T - attachment based.)

    In your SMU presentation, you made a statement about attachment and how is is "useless" (or something to that effect), and I couldn't believe my ears. The same week I received my issue of Psychotherapy Networker and knew I couldn't miss this webinar.

    The fact is, I think you have some incredibly valid, useful, and spot-on material. Differentiation is absolutely necessary, and as my practice is at least 50% couples (also all private pay, and my drop out rate is also very slim). But I would also add that Attachment Theory is absolutely necessary.

    The reason couples come in, usually, is because they are insecurely attached - and they became insecurely attached BEFORE they got into their dysfunctional marriage. Now, they're on the verge of divorce and have little to no insight into their OWN life, let alone their spouse's.

    My approach is very much attachment based on an individual level, because you can't have a differentiated, healthy couple without a secure adult. Attachment theory is rich in education: brain-based information, early attachment effects, how we process information, etc. The goal therefore, isn't to create a couple that's attached to EACH OTHER, the goal is to create self-actualized individual, who can peer into their inner world AND their spouses world.

    When there is discord in the marriage, it's because of what the individual client brought to the marriage, not what they developed IN the marriage. It's about understanding the self, and being able to stand on their own feet. It is about becoming secure in their own life, not securely attached to their spouse.

    The bottom line, for me, is that both attachment theory and differentiation are useful and necessary for successful couples and individual therapy. To claim that attachment theory is unnecessary is missing a huge component of LIFE, frankly. This marriage will not last (to ignore it is to cover up some very important information about personhood and individuality, I think). Differentiation is also an important LIFE skill - I think you'd agree.

    As marriage mimics life (early life, adolescent life, work life... all systems in life), it would be well worth it to develop material rich in BOTH of these areas (attachment and differentiation). If we let the data and research speak for itself, why would we exclude either?

    Thank you for your time and information during these sessions!

    Jennifer Ryan, M.Ed., LPC
    I Choose Change PLLC
    http://www.ichoosechange.com
    Reply
    • Not available avatar David Schnarch 05.03.2011 09:25
      Dear Jennifer,

      I have wonderful memories of the SMU presentation. They expected 200 people and 400 people showed up. Sorry if you were one of the students who ended up standing in the back of the room.

      I’m glad you find merit in some of my ideas. Thanks for taking the time to write your thoughtful response. It gives me a chance to correct a misperception and also further the discussion. First off, I encourage you to keep disbelieving your ears. I don’t think “attachment is useless.” If I were working with young children I’d very much focus on attachment as core issues, and probably make it the primary focus of therapy. By the time I was working with adolescents, and certainly adults, however, I would increasingly focus more on differentiation. The issue, to repeat myself, is not theory, it is praxis.

      Differentiation theory is not antithetical to attachment. It very clearly and explicitly includes attachment. (See diagrams in Passionate Marriage and Constructing the Sexual Crucible. To quote myself, differentiation is the ability to balance attachment with emotional autonomy and self-regulation.) It differs from attachment theory in that differentiation theory sees differentiation as the over-arching process and attachment occurring within it. Attachment theory, conversely, sees attachment as the over-riding process and differentiation occurring within it. See prior posts where I’ve questioned whether differentiation-based therapy or attachment-based therapy is superior in facilitating both differentiation AND attachment.

      I’m delighted you have a self-pay practice with low drop out. Good for you! In this way our practices are alike. You write, “The reason couples come in, usually, is because they are insecurely attached.” Here our practices differ. Couples come to see me because they’ve had affairs, or don’t have sex, or have sexual dysfunctions, or lack intimacy, or hate each other, or are on the brink of divorce, or their child committed suicide, or many other things. Apparently attachment theory lets you know why clients are coming to you before you even see them. Differentiation theory doesn’t let me know that. Are my clients poorly differentiated? Sure. Does that greatly contribute to their problems? Sure. But is that why they have affairs, no sex, anorgasmia or rapid orgasm, no intimacy, hate each other, or their kid killed themselves? I have to talk with people in detail before I know what’s causing any of these.

      What do I think is useless? I think a therapy that, for instance, takes people who really hate each other for very good reasons given the things they’ve done to each other, and shifts the framework to them being insecurely attached, and attributes this to prior childhood experiences, is useless in helping them deal with hatred. Moreover, besides useless, I think it creates a serious problem by producing pseudo-differentiation—a false increase in functioning that partners can maintain only as long as they buy “we don’t really hate each other, and we’re not hateful people, we’re just insecure and poorly attached.” Hatred is a VERY powerful real attachment.

      I agree “you can't have a differentiated, healthy couple without a secure adult.” But this doesn’t prove attachment-based therapy is the way to go, it’s just a tautological truth. You believe a secure adult come first, and it comes from getting “safety and security.” I often find differentiation comes first, couples go through insecurity, and become secure adults with a healthy relationship.

      I couldn’t agree more that attachment theory is rich in brain-based information (especially now), early attachment effects, and how we process information. But your leap to “therefore therapy goals” doesn’t necessarily follow from this. (By the way, have you noticed how many posts jump from attachment theory to goals, without ever dealing with practicalities of application?)

      I’ll bet lots of attachment therapists fell out of their chair when they read you don’t think the goal of therapy is to create a couple who are attached to each other.

      I am awed but not surprised by your statement, “When there is discord in the marriage, it's because of what the individual client brought to the marriage, not what they developed IN the marriage.” This is what I call the “if it weren’t for our lousy childhoods, marriage would be wonderful” view of marriage” You completely wipe out the natural ecology of love relationships, which present many conundrums, two-choice dilemmas, etc. that are IN marriage and which creates HUGE discord in normal healthy couples. (I use a great example to open my new book, Intimacy and Desire: The Low Desire Partner Always Controls Sex.) When couples handle these dilemmas poorly, which poorly differentiated couples do, tremendous discord develops IN marriage. In this case I’ll grant you that people with attachment problems also handle this poorly, because it still makes the point that it’s not all about individual problems brought into the marriage. The fact that someone’s mother had messy affairs and her parents divorced early neither creates nor changes the difficult reality that the low desire partner always controls sex. It does shape how someone (mis)handles this reality, but helping people become mature enough to handle this reality doesn’t occur primarily talking about the past. It actually interferes, because it conveys the message the couple’s handling of this problem should be primarily dictated by consideration for someone’s past.

      You write “marriage mimics life (early life, adolescent life, work life... all systems in life),” and here I also strenuously disagree. First, marriage doesn’t mimic life, it IS life. Marriage is not a metaphor. It is not a recapitulation of childhood, although childhood issues certainly surface within it. Marriage has its own dynamics and issues, which are not reducible to childhood issues, and which fly in the face of attachment-based therapy for adults. I’ve spent 30 years writing about these dynamics of marriage, which attachment-based therapists often completely ignore in treatment, and conveniently overlook when I say attachment-based therapy doesn’t line up with the way adult love relationships operate. Your response illustrates one of my greatest objections to attachment-based therapy, which I greatly appreciate.

      Thanks for your response.
      Reply
  • Not available avatar David Schnarch 05.05.2011 19:40
    Those of you who have been following this thread might be interested in a blog I’ve posted on PsychologyToday.com entitled “Happy Mother’s Day to Mothers of Basic Decency.” It touches on the notion that parents always do the best they can, which is relevant to the discussion here. Responses to the article from women are particularly instructive.

    http://www.psychologytoday.com/blog/intimacy-and-desire/201105/happy-mothers-day-mothers-basic-decency
    Reply
  • 0 avatar penelope andrade 05.07.2011 22:43
    Finally got to listen to this deliciously provocative webinar and read the thoughtful posts and generous replies of David Schmarch. I trained with Murray Bowen and Tom Fogarty for 4 years in the 70's. I'm grateful for the notions of differentiation I learned then.In the many years since I've integrated Psychosynthesis, Bioenergetics, Somatic Experiencing (none of which were originally attachment based or even primarily relationally oriented.) My focus has been primarily on helping clients (individuals and couples) with self regulation and differentiation of self. I even developed my own method, Emotional Medicine, to help clients learn how to use brief embodied mindful emotional discharge and focus on ensuing relief to restore states of calm resourceful coherence in a matter of minutes.

    However, recently I've discovered and begun training in the attachment based Accelerated Experiential Dynamic Psychotherapy AEDP. After 40 years as a therapist, AEDP has finally given me a methodological vehicle to more precisely and systematically answer in my practice the question Thomas Nolan raised " How and under what circumstances will the client look at themselves." (And I would add the equally important questions, how and under what circumstances will the client take responsibility for what they see about themselves and then take action for transformation.)

    In my experience the answer to those questions is love -- sometimes tough, sometimes tender. The ability of the therapist to be what Diana Fosha calls a 'true other' for the client, to undo the aloneness which often makes facing the disgusting truth of self at worst terrifying or unbearable. This moment by moment tracking and presence for clients is nothing like trivial empathy or 'coddling.' It is profound.

    I know that most people who get caught in 'heart eating', disgusting behaviors do not go to bed at night thinking they are terrible people. The power of the unconscious and its defensive gargoyles should not be underestimated. While people are surely always mind mapping, they are also surely not always aware of what they know, and are even likely to be actively subconsciously working hard not to know what they know.

    From this brief taste of Snarch,I also wondered whether he was also underestimating the immobilizing effects of trauma on people's ability to be present for the themselves at best or worst.

    If getting people to confront their dark sides and restore the resources of self at best were essentially a matter of someone telling them the unsavory truth about themselves, we wouldn't as a nation need much therapy other than Dr Laura and Dr Phil.

    I haven't seen David Snarch work, but I imagine there is some profound quality of love and being a 'true other' present in his collaborative confrontation in the service of differentiation.

    However, along with some other posts, I think that there is a self selection process for Snarch's practice in which his reputation (e.g."I hear you're tough and will kick my ass"draws to him people who would respond better to tough love than tender love and as one post said, these folks are ready for action. I'm not so impressed that these who already know what they're in for don't leave.

    Since AEDP gives therapists' blatant permission to love, I've been able to come out of the closet with my true heart for clients. I've now found clients taking more transformative, individuating type risks, more quickly than ever.

    In my experience, couples not only read each other's minds (whether consciously or unconsciously) they feel each other's feelings. They are vulnerable (as in open and susceptible to being impacted and yes, even wounded, by each other's emotion) If one part of the couple is good at suppressing emotion, the other part will typically experience the emotion for both of them. While this does not mitigate the need to take responsibility for one's emotional responses no matter what the dyadic influences, or historical wounds, or phase of the moon, etc etc, it makes dyadic regulation for couples a practical option which takes this shared reality into account.

    Finally,since I experienced Snarch having a mind like a steel trap while being amazingly , articulate, confident, and charismatic, I am concerned about how much of his clients' collaboration is compliance and/or submission to such a powerful (father) figure. I appreciated his stressing the need to turn a combative alliance into a collaboration. I'm not sure, however, whether just this intention coupled with his intuitive clarity is enough to mitigate the authoritarian aspects of his method. Once clients' are dazzled by his intuitive insights and forceful of personality, are they going to be truly comfortable in disagreeing, speaking up, differentiating from him, etc?

    Other than the drop out rate, what are the outcome studies of the Crucible method? How well do folks fare down the line?

    Full disclosure: my husband of 20 years and I have recently had some EFT couples' therapy here in SD. It was the most helpful couples work we've ever experienced.

    All that being said, this wonderful webinar has gotten me reviewing a client situation where I might need to step up my tough love. THanks for all of this ! And Rich, you did a great job reframing and managing this torrent of interesting and provocative material.
    More thanks.

    Penelope Young Andrade, LCSW
    San Diego, CA



















    Reply
    • Not available avatar David Schnarch 08.29.2011 10:28
      Dear Penelope,
      Thanks for your comments. I’ve been mulling them over for some time because they raise some very interesting issues.

      You write that attachment based Accelerated Experiential Dynamic Psychotherapy AEDP gives you a precise systematic answer to Thomas Nolan’s question " How and under what circumstances will the client look at themselves,” and how to facilitate clients take responsibility for what they see about themselves and take action for transformation.. In you experience the answer is “love.”

      I, for one, am not comfortable with approaching this under the heading of “love.”’ If you’re concerned about issues like transference and counter-transference (e.g., you’re reference to me being a ‘father figure’), you looking for trouble by labeling the solution “love.”

      If “love” is the answer, then we should be teaching “loving” as a clinical technique or process in graduate schools, testing students for their ability to love in order to graduate, and have this assessed as part of state or national licensing in the helping professions. Tenure is hard enough to get in universities—should we now add “teaches loving” to publications, teaching and committee work as tenure requirements? Should we assess new faculty for their ability to “love” or “instill ability to love in students?”

      Given that the divorce rate among mental health professionals isn’t phenomenally lower than the general public, what does this say about our ability to love? Does the general public have the right to expect that by virtue of our professional training, we are better at loving? Besides the methodological problems and never getting consensus (outside AEDP) on defining “clinical good loving,” this is more likely to bring up therapists’ myriad idiosyncrasies and problematic personal dynamics. Moreover, therapists operating under the rubric of “go love your clients” will exacerbate the problem in our field in which therapists endeavor to get clients to “trust” them. Should we tell clients therapy is based on loving them? Should the client or therapist be the one to decide when the therapist is being “loving?” What if the client thinks “no,” but the therapist thinks “yes?” Can a therapist be “too loving”? Is “too loving” an oxymoron?

      I think going down this road is fraught with pitfalls. Sure, it lines up with attachment view that what messes up a lot of people is lack of love. But in our Crucible Therapy workshops we teach, “The love you get can mess you up 6 times worse than the love you never got.”

      I think you’re much closer to an answer to what makes people confront themselves when you touch on “moment to moment tracking and presence for clients.” Besides personality or demeanor,, “presence” is determined by what a therapist does or doesn’t do, which is greatly determined by his or her pictures of reality. This will show up in things like “While people are surely always mind mapping, they are also not always aware of what they know...[they are] actively subconsciously working hard not to know what they know.” How do you work on something actively subconsciously? If they are working hard to not know what they know, should the therapist relate to the client as if they “know” or “don’t know?” If they have to work hard at not knowing, is it truly subconscious? I think you are not alone in this quagmire, which results from having one leg in 20th century psychology and the other leg 21st century brain science.

      Moreover, I think your point about “If one part of the couple is good at suppressing emotion, the other part will typically experience the emotion for both of them,” actually argues AGAINST dyadic regulation. First off, this is not a shared reality, especially to the person who you deem as “suppressing emotion.” This is the therapist’s reality, which the ‘other partner’ will like, but gives you an unbalanced alliance in treatment. Secondly, what the “other partner’ experiences is not a virtue, because “experiencing the emotion for both of them” helps neither of them. At best you’re describing borrowed functioning, and at worst you’re pointing to someone who is overly emotional. The point is that both people in what you’re describing usually have difficulty regulating themselves. To suggest they then should try to regulate each other is inviting a mess, because they are ALREADY trying to regulate each other. You are perhaps the 1000th therapist who’s tried to present a case for deliberate co-regulation in dysfunctional couples, and not one has ever made sense (to me). What is it that makes this idea so seductive and so cherished that therapists stop thinking straight?

      I’m happy you can imagine in my work “there is some profound quality of love and being a 'true other' present in his collaborative confrontation in the service of differentiation”. But I would never suggest I love my clients, nor suggest that the basic motivator of my interventions with them was my love for them. For the most part, I wouldn’t go near this, but read Passionate Marriage if you want to see a rare case where a client struggled with this productively. The client, who had made tremendous progress, asked me if I loved her. I refused to answer and turned it around so it became an issue of her “being present for herself” (validating her own perception of me.)

      You wonder if I am “underestimating the immobilizing effects of trauma on people's ability to be present for the themselves at best or worst.” I guess this could be true, but I work with people who’ve had three or four unsuccessful attempts at conventional trauma therapy, who finally get over their prior trauma in our therapy. I think very often therapists underestimate people’s resilience and approach clients in self-fulfilling ways that convince them they are seeing the “nature of trauma” rather than the power of co-construction in therapy.

      The topic of therapeutic co-construction is also perhaps the best way to address your comment about “client selection bias” in my practice (e.g., my clients are ready for action, they want or respond better to a tough therapist, etc.). My answers to prior assertions in this blog speak for themselves. It’s too glib and easy to suggest this is why people don’t leave therapy when I make moves other therapists feel would make their own clients walk out. How about if you and I generate multiple hypotheses, as we teach in my approach: You’ve certainly come up with one possibility. But another is that I can take an “unselected” case and co-construct it with clienst in ways that makes them tolerate of and benefit from more collaborative confrontation than most therapists are comfortable with. I think a huge portion of our profession can’t imagine the incredible impact (for better and worse) they have in co-constructing CLIENTS, not just therapeutic reality, The responsibility this places on therapists is more than most of us want to tolerate. The easy way out is conceptualizing this is the way my clients walk in the door. You may want to go back and listen to a presentation I did at the Networker Conference several years ago entitled, “The Art of Constructing Workable Clients.”

      Likewise, for your concern that much of my “clients' collaboration is compliance and/or submission to such a powerful (father) figure” and “the authoritarian aspects of his method. Once clients' are dazzled by his intuitive insights and forceful personality, are they going to be truly comfortable in disagreeing, speaking up, differentiating from him, etc?” You’ve got a variety of ideas mashed together here:

      First, how did my approach become tacitly “authoritarian?” There’s a difference between being an authority (an expert) and being authoritarian. Given the foolishness of our profession in the 1980s and 90s (and still some today), where leaders in our field “proved” their expertise by claiming the client, and not themselves, to be the true expert on their situation, this is a tough one for therapists to get over. Here’s my take: if you’re not an authority, you’re guilty of malpractice because the law says the public has a right to expect you have a level of knowledge and ability that supersedes that of the average person. (If you’re ever sued for malpractice, just get on the stand and tell the jury you’re not an expert, the client is the true expert, and get ready to rip up your license to practice.)

      Secondly, if you really are an authority, there’s no need to be authoritarian because it’s a stupid move and a waste of your expertise. I guess you could say what I just wrote is authoritarian (I think its good clinical strategy). I happen to think attachment-based therapy is so hugely authoritarian it approaches hegemony, and too many therapists are too “bedazzled” to speak out against it. I think this is particularly pernicious because therapists who don’t openly confront clients delude themselves into thinking they’re not dramatically co-constructing reality.

      While I appreciate your characterizations of my responses as articulate and incisive, it almost sounds like perhaps my clients would be “safer” if I was slow, fuzzy-thinking and diffuse. I was thinking I needed to get better at what I do, not worse. And as for clients being too intimidated to disagree or challenge me, you sure haven’t been a fly on the wall in my office.

      Finally, I do appreciate your comment that this webinar has gotten you reviewing where you might need to do more collaborative confrontation with clients. What a loving (tongue in cheek) thing to say!

      Thanks for taking the time to add your thoughtful response.

      David Schnarch
      Reply
  • 0 avatar lorie teagno 05.10.2011 17:00
    I really enjoyed and felt enlivened by David Shcnarch's presentation and felt like a professional "prayer" was answered as I have struggled in the past decade with the direction couples therapy was going with the dominance of attachment, neurobiology and EFT focus as THE ANSWER, the ONE TRUE path to helping clients become whole, satisfied and intimate beings and partners.

    While the attachment research has been an asset to clinicians, where I find myself confused and perplexed is when the research on attachment is applied to clinical interpretations of what a resilient, loving adult relationship is and should be. Maybe it’s me, but so often I hear at these conferences the call to help our clients create the pristine, secure attachment with their significant other that they “should have had” or “needed” with their primary caregiver.

    I am of the belief that human beings and all beings always have the opportunity to evolve or change, and sometimes not at our own initiation. That is the nature of existing or co-existing. We are influenced by factors both within and outside of ourselves. To this end I have always believed that the original attachment bond is certainly important to the social, emotional and psychological aspects of the infant, but like so many systems in the human and other parts of nature, there is overlap in the system designed to ensure survival. Thinking along these lines, I believe that any of us who do not receive optimal bonding have innumerable opportunities in our lifetimes to change, repair or replace that bonding, and that the choice is the most reliable when it begins with ourselves.


    Before we can choose a good partner and trust our choice we must have a strong, clear and realistic view of ourselves. We must essentially learn to trust ourselves. Given the difficulties inherent in being human, we will all often be disappointed by others and ourselves. If we put our early unfinished bonding experience in the laps of our partners before we assume its full responsibility, I believe we limit our personal growth and the eventual growth of our relationship with our partners.
    If I make my partner responsible for my wholeness, my history and my sense of connection, then I believe we are stopping short of what individuals and couples are capable of in terms of deep, resilient and abiding love and commitment.


    Loving and being love is ongoing work and joy. Susan Johnson, a highly regarded therapist in the marital field for the last decade plus, asserts that her therapeutic approach, Emotionally Focused Therapy, EFT ensures no relationship relapse because it creates emotional accessibility and responsiveness in partners. I do not doubt that it can create some of both of the latter, but I would add that creating a sense of the individual as a competent, satisfied separate self who is also connected to another especially during conflict is a more adaptive model of relationships and human beings. I also do not believe that no relapse is likely in any human being. As Freud said,"regression in the service of the ego" or as I say it less eloquently, in the face of stress, some regression is likely and temporary.

    Susan Johnson also adds that “A secure bond is the best protection against helplessness and meaninglessness”. There is no doubt that on the face that statement is appealing, but I do not think it is as true as an alternative statement, “A secure bond with oneself (a clearly defined, separate self) and a connection with another or others is the best protection against helplessness and meaninglessness.” Separate and connected and an expansive sense of self give us constant growth opportunities.



    I have spoken to my colleagues over the last decade decrying the lack of an open a dialogue between the attachment proponents of marital therapy and those of us who huddle under the umbrella of Differentiation theory- at present a loosely knit group of practitioners. I am so relieved to see this beginning!

    The Differentiation therapists assert that the most resilient relationships go through developmental stages that move beyond a more symbiotic relationship to one that allows for, expects and benefits from personal differences. In fact, we assert that the differences are fodder for growth. We also view the tension that develops in relationships much like biologists do as the necessary fuel for growth, evolution and change.

    A dialogue with all clinicians who are curious, respectful and committed to the scientific agenda of discovery, sharing and respecting is what I am suggesting.
    It is unlikely that ONE group is correct; can we make room for mutual respect of our differences that benefits our field, our clients and ourselves?


    Maybe I’ve been in the field too long and I am nostalgically recalling (and glamorizing) the days when the videotape series was made with one client interviewed by many of the pre eminent therapists representing the various therapeutic approaches at the time: Carl Rogers, Fritz Perls, Albert Ellis, and the like. I would like to see us return to a more expansive and mutually open and respectful discussion so we as clinicians and leaders in our field can contribute to the evolution of marital therapy; a therapy that has place at the table for both attachment and differentiation theorists and clinicians as well as others.



    I am hopeful that the Networker has started this discussion so that the field can also evolve and become it's best differentiated and differentiating as well as attached "self".



    Lorie J. Teagno, PhD

    co-drector The Relationship Institute
    La Jolla, CA
    Reply
    • Not available avatar David Schnarch 08.29.2011 10:39
      Hi Laurie,

      I’m glad you liked my presentation and input. Thank you for the kind words. Right you are that, “A secure bond with oneself (a clearly defined, separate self) and a connection with another or others is the best protection against helplessness and meaninglessness.” Your characterisation is not just more accurate and more balanced, you obviously see what’s off in the world of attachment.

      I share your nostalgia for videotape series made with one client being interviewed by therapists of different therapeutic approaches. I long for the AAMFT Masters Series, where you could watch leading clinicians work in real time with clients. This electric, authentic, and courageous display of expertise is sadly missing at major conferences.
      There is much to be said for dialogue and debate between alternative clinical approaches. But all of this amounts to words. The real issue is what therapists do. That’s what I always want to see. I don’t want to hear how someone conceptualizes treatment, show me what you do and I’ll conceptualize it for myself. I’d be happy to participate in comparative live demonstrations, and it could greatly advance the art and science of MFT.

      Thanks for your comments,

      David Schnarch
      Reply
  • 0 avatar Nick Child 06.11.2011 08:38
    I have in me enough traits in common with David's robust direct straight-talking personality and clinical approach to like him and it. I came from a nice but confusing English background that I qualify as like "cotton wool"; I have settled into Scotland because of its therapeutic sharp edges (intellectual, wit and humour, confrontation and anger, mountains and weather). In my training in an adolescent in-patient unit, I learnt a range of ways to engage and confront young people, and sometimes their families too. It didn't come easily to me; yet I continue to be forthright and idiosyncratic if not still so rebellious in lots of ways. Family Therapy originally appealed to the bossy caring side of me too, and I have not liked learning how to be much more reflective and non-directive. So you can see the links to David in there!

    But to hold his line and build a career and an institute means that he is not just a bolshy rebel intent on differentiating himself and his ways unconstructively from everyone else as most of us rebels are! He must be engaging and integrating and collaborative with clients and colleagues alike - attached at least to the efficacy and belief in his ideas and skills.

    Over many years I could see my development and continuing learning being a way to hold but moderate my too straight-talking side, to find ways to speak to truth without returning to "cotton wool". Having watched David's challenging contribution to this webinar "debate" I guess that if we saw him at work with clients, we would see more of his real care and commitment to his clients that must hold them safely when he sets out to confront them with the truth he sees. They must sense, as children do with silent or powerful parents, that underneath he loves them and wants the best for them.

    I worry that 4 hour sessions of anything can lead to brain washing, but presumably clients would have told the world about that long ago if it happened with his therapy.

    I guess my thought is: Are there a number of ways to talk straight about the truth, some of them not as plainly blunt and confronting as David's? If so, then the truth of "differentiation therapy" may be at least as powerful even though less "in your face".

    As a child psychiatrist in a welfare state NHS system (less ruled by DSM or who is paying me), I would often give unusually straight opinions - eg about unloved or rejected children, children in care and going down hill steadily despite the "caring" agencies - to them and in front of family and other agency workers involved at case conferences etc. It seemed to me that the pseudo-care from all quarters (which is what everyone expected - would have complained about if anyone didn't do it) was the main cause of the problems!

    Now I think about it, there were all kinds of other ways that I "called a spade a spade" - apologies if that is now non-PC, but there you go! Or at least didn't call it DSM Category F123 and took the flack for not doing what people wanted me to.

    So this is me trying to identify and remind myself and take back on a core truth of David's approach, while allowing that there may be a range of ways to carry it out.

    Nick Child
    Now a Family Therapist
    Scotland
    Reply
    • Not available avatar David Schnarch 08.29.2011 10:51
      HI Nick,

      I was recently in Glasgow to give a plenary at the World Congress of Sexology, and traveled a wee bit in the highlands and Isle of Skye. I understand why you revel in the intellect, humor, direct talk and mountains. Not sure about the weather because we hit a rainy spell, but it made me understand why they invented Scotch (25 year old single malt is indeed the “water of life”). Lovely people and beautiful country, although I learned the “Scottish Sarah Palin” is dismantling decades of progress in sexual health care services.

      I appreciate not being characterized as a “bolshy rebel intent on differentiating himself and his ways unconstructively.” I had to look up “bolshy,” it being “an “emotionally charged British term referring to extreme or difficult-to-manage rebellious radicals.” If you read the opening of this blog thread, you know that in the U.S.A. we refer to them as “jerks.”

      People who have seen me work with tend to agree with your assumption that you see real care and commitment when I collaboratively confront my clients. (I’ve regularly done live demonstrations for over 20 years). However, I’d stop short of saying that I love my clients, although I deeply care for them and want the best for them. I also think many of them wouldn’t trust me—or any other therapist- if I professed to love them.

      I get uncomfortable when therapists speak of loving their clients because it raises the specter of approaches where (a) the therapist presumes to be “the good parent that clients never had,” (b) clients are presumed to need more love rather than needing to be more loving and lovable and (c) therapists are generally presumed to be capable of love. Graduate training doesn’t make MFTs more capable of love. And if MFTs are so good at loving, I’d expect they’d have few divorces than other people, which they don’t.

      I know this is going to piss off some therapists—who will think I’m a bolshie rebel—so I’ll clarify this by saying I’m not suggesting therapists are generally an unloving lot. I’m saying there’s no empirical evidence that they are, as a group, more loving than other people, or that it’s good to center therapy around this. I’m concerned that therapists presume this ability for themselves, and I’m worried about therapy where therapists act loving, empathic, and unfailingly accepting towards clients when they don’t do this at home. (I’ve discussed this in more detail in a preceding recent post so I won’t belabor the point here.)

      I’m also worried about “therapeutic loving,” “empathy,” and “safety” being co-opted and defined only as attachment-based therapy stereotypes it. My empathy for clients shows in my willingness to see the horrible and speak the unspeakable in order to help them live better lives. The safety my clients experience is my ability to modulate my caring, maintain collaborative alliances with people who only know about collusive or combative alliances, and constantly confronting myself about how I might be wrong. Our field needs broader views of what empathy and empowering people looks like.

      This brings us to a point you make so well: If we’re going to be have more diversity in what we consider empathy and safety, we’ll also need some diversity in how differentiation-based therapy is conducted. You ask, “Are there a number of ways to talk straight about the truth, some of them not as plainly blunt and confronting as David's? If so, then the truth of "differentiation therapy" may be at least as powerful even though less ’in your face’.” How right you are.

      When Ruth Morehouse, a wonderful differentiation-based therapist (who happens to be my wife) does therapy, her style is softer than mine. And, believe it or not, I can be very gentle too, everything is not “slash and burn and take no prisoners.” “In your face” does not define differentiation-based therapy and after a while it’s stale and ineffective However, trainees who have seen both Ruth and I conduct sessions say that while our styles are indeed different, the similarities are also unmistakable. There is room for differences in style and the persona of the therapist to come forward, but (at least in Crucible Therapy) these are variations around a solid core. I’ve learned it isn’t as simple as “different strokes for different therapists,” and just because someone says they are doing “their style of differentiation-based therapy” doesn’t make it differentiation-based therapy. These are thorny issues that remain to be resolved as more therapists aspire to this kind of work. I, for one, can’t wait.

      I’m delighted to see you have just a touch of “bolshie” in you. Thanks for your thoughts,
      David
      Reply
      • 0 avatar Nick Child 08.30.2011 03:43
        Hi David
        Many thanks for your extensive response here. I think I used the word "love" too loosely since I would agree with what you say.
        "Bolshy" is short for Bolshevik, so it would probably have even stronger weight in the US given that facebook doesn't even allow the choice of "socialism" as one's political colour!
        Best wishes
        Nick
        Reply
  • Not available avatar David Schnarch 08.29.2011 10:58
    To previous posters and readers of this thread:

    Earlier, several posts asked for a more detailed articulation of my views on differentiation, and how it differed in substance from an attachment viewpoint. At that time I said I was writing some things on this topic and would announce when they were available. For those who are interested, there is now a series of articles I’ve written on the Psychology Today blog that are relevant to this ongoing discussion. So far 100,000 people have read these articles and there's currently a very active discussion going on about the last one.

    Thanks,

    David Schnarch

    http://www.psychologytoday.com/blog/intimacy-and-desire/201011/charles-manson-please-save-marriage-family-therapy

    http://www.psychologytoday.com/blog/intimacy-and-desire/201105/happy-mothers-day-mothers-basic-decency

    http://www.psychologytoday.com/blog/intimacy-and-desire/201105/normal-healthy-couples-have-sexual-desire-problems

    http://www.psychologytoday.com/blog/intimacy-and-desire/201105/people-who-cant-control-themselves-control-the-people-around-them

    http://www.psychologytoday.com/blog/intimacy-and-desire/201105/people-who-cant-control-themselves-control-the-people-around-them--1 ({Part 2)

    http://www.psychologytoday.com/blog/intimacy-and-desire/201106/sexual-relationships-always-consist-leftovers

    http://www.psychologytoday.com/blog/intimacy-and-desire/201106/people-have-sex-within-the-limits-their-development

    http://www.psychologytoday.com/blog/intimacy-and-desire/201106/sex-and-self-development-between-the-sheets

    http://www.psychologytoday.com/blog/intimacy-and-desire/201106/decoding-the-logic-sexual-relationships

    http://www.psychologytoday.com/blog/intimacy-and-desire/201108/developing-self-greatly-shapes-your-sexual-desire

    http://www.psychologytoday.com/blog/intimacy-and-desire/201108/do-you-want-your-partner-stroke-your-ego-or-your-genitals
    Reply
  • Not available avatar Colleen Long 11.12.2011 12:24
    First of all, let me say that I am still glowing in the throes of post-schnarchian training from last weekend's four day workshop in LA. The workshop opened my eyes, re-invigorated me as a therapist, as well as a soon wife-to-be.

    My one hiccup is that I don't understand how we work with clients that never had a secure attachment to begin with. We are all (or most people) familiar with the studies done on rat pups, that found severe malformation in stress regulation pathways in the absence of a mother. I also think most of us are familiar with the cloth monkey experiment, and the romanian orphans. If one never develops the physiological pathways required to self-soothe, and thus- differentiate- how do we use this approach?

    Thanks again for intimacy and desire, passionate marriage, and most of all- for helping me re-ignite the passion and drive I have to be a therapist. Best, Colleen Long
    Reply
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